
Background: Women with Sjögren’s syndrome (SS) are more likely to experience vaginal dryness, dyspareunia and reduced sexual function than healthy controls 1 . There is limited data investigating relationships with psychosocial influences, such as coping mechanisms, illness perceptions, partners behaviours and relationship satisfaction.
Objectives: To investigate associations between sexual function and psychosocial parameters in women with SS.
Methods: Cisgender women aged 18+, diagnosed with SS, were invited to participate in a cross-sectional online survey. Ethical approval and informed consent were obtained. Participants completed the Female Sexual Function Index (FSFI), EULAR Sjӧgren’s Syndrome Patient Reported Index (ESSPRI), NRS scale for vaginal dryness (0-10), Profile of Fatigue and Discomfort (ProFaD), Cognitive Emotion Regulation Questionnaire (CERQ), Brief Illness Perceptions Questionnaire (BIPQ), West-Haven Yale Multidimensional Pain Inventory (WHYMPI – Part II) and Maudsley Marital Questionnaire (MMQ – Marital subscale). Associations between the FSFI and the outcome measures were assessed using Spearman’s correlations. Variables that significantly correlated with FSFI total score were entered into a backward stepwise multiple regression.
Results: The survey was completed by 98 women (M = 48.13, SD = 13.26), 70.4% were diagnosed as having primary SS (disease duration range = 3 – 348 months); 43.8% were premenopausal and 48% were postmenopausal. Vaginal dryness was reported by 92.9% of participants, and sexual dysfunction was identified in 85.2% (n = 69/81) of cases (<26.55). Participants who were not sexually active in the previous three-month period (n = 17) were excluded from analyses as inactivity may cause a low FSFI score which may be incorrectly construed as sexual dysfunction. Reduced sexual function was significantly associated with increases in age, vaginal dryness, mental fatigue (ProFaD), self-blame, rumination and catastrophising (CERQ), consequences and identity (BIPQ), negative partner responses (WHYMPI) and relationship dissatisfaction (MMQ). Reduced sexual function was also significantly associated with decreases in positive reappraisal and perspective (CERQ), personal control (BIPQ), solicitous responses and distracting responses (WHYMPI) (
Associations between sexual function and psychosocial parameters
| FSFI total | ||||
|---|---|---|---|---|
| r s | p | 95% CI (LB, UB) | ||
| Age (years) | -.270 | .015 | -.467 | -.049 |
| Disease duration (months) | -.030 | .793 | -.253 | .196 |
| Relationship duration (months) | -.180 | .119 | -.396 | .054 |
| VAS Vaginal dryness | -.350 | .001 | -.533 | -.136 |
| ESSPRI total | -.165 | .141 | -.376 | .062 |
| ProFaD Mental Fatigue | -.294 | .008 | -.486 | -.074 |
| CERQ Self-Blame | -.264 | .017 | -.461 | -.042 |
| CERQ Rumination | -.296 | .007 | -.488 | -.077 |
| CERQ Positive Reappraisal | .469 | .000 | .273 | .628 |
| CERQ Perspective | .341 | .002 | .126 | .525 |
| CERQ Catastrophising | -.499 | .000 | -.651 | -.310 |
| BIPQ Consequences | -.237 | .033 | -.438 | -.013 |
| BIPQ Personal Control | -.288 | .009 | -.481 | -.068 |
| BIPQ Identity | -.294 | .008 | -.487 | -.075 |
| MMQ | -.282 | .013 | -.483 | -.054 |
| WHYMPI Negative Responses | -.252 | .028 | -.457 | -.021 |
| WHYMPI Solicitous Responses | .267 | .020 | .037 | .470 |
| WHYMPI Distracting Responses | .311 | .006 | .085 | .506 |
Note. N = 81. Associations that were not significant are not shown.
Conclusion: Women with SS using positive coping strategies have better sexual function than those with negative coping strategies. Learning positive coping strategies may be an important line of approach for managing sexual dysfunction in SS.
REFERENCES:
[1]Priori R, et al. Quality of sexual life in women with primary Sjögren syndrome. J Rheumatol . 2015;42(8): 1427-31.
Disclosure of Interests: None declared