fetching data ... 
Background: Chronic disorders can impact several aspects of an individual’s daily life, including sexual health. The influence of rheumatic diseases in this domain is poorly explored, with a lack of validated assessment tools and few real-world studies.
Objectives: This cross-sectional study aimed to evaluate sexual dysfunction in patients regularly followed in a Rheumatology outpatient clinic. The assessment was conducted using the Massachusetts General Hospital‐Sexual Functioning Questionnaire (MGH‐SFQ). This tool consists of five questions, each scored from 1 to 7, addressing five domains: sexual desire, arousal, ability to achieve orgasm, ability to attain and maintain an erection (men) or lubrication (women), and overall satisfaction. Higher scores indicate better sexual health, and one or more answers below 2 suggests sexual dysfunction.
Methods: Between 20/05/2024 and 30/11/2024, patients attending the Rheumatology outpatient clinic were asked to complete the MGH‐SFQ. Clinical, demographic data, disease activity scores (DAS28, ASDAS, SLEDAI, ESSDAI) and patient reported outcomes (HAQ, HADS, FACIT, SF36) were also collected. Statistical analysis was performed using SPSS version 29, with p-values < 0.05 considered statistically significant.
Results: A total of 92 individuals were included, 70.7% female (n=65), with a mean age (±SD) of 56.1 (±15.07) years and the following diagnoses: spondylarthritis (n=34, 37.0%, including 17 psoriatic arthritis, 10 non-radiographic axial spondylarthritis and 7 ankylosing spondylitis), rheumatoid arthritis (n=27, 29.3%), systemic lupus erythematosus (n=12, 13.0%), systemic sclerosis (n=11, 12.0%), fibromyalgia (n=5, 5.4%), and Sjögren disease (n=3, 3.3%) (Table 1). As for sexual function, patients with fibromyalgia presented the lowest scores (Table 2). However, there was no significant difference between disease groups (Kruskal-Wallis test and Dunn-Bonferroni post-hoc test). At least one MGH-SFQ response < 2 was identified in 29.3% (n=27) of the patients; although the Fisher-Freeman-Halton exact test did not show differences between disease groups (p=0.061), it is noteworthy that 80.0% of patients with fibromyalgia reported at least one domain score < 2 (Table 2). No correlation was found between disease activity scores and MGH‐SFQ (Spearman’s correlation coefficient). However, there was a correlation between HAQ score and sexual desire domain (p=0.031, rs=-0.227); between HADS depression score and all MGH-SFQ domains (sexual desire p<0.001, rs=-0.362; arousal p=0.003, rs=-0.302; orgasm p=0.024, rs=-0.236; erection/lubrification p=0.034, rs=-0.221; overall satisfaction p=0.002, rs=-0.320; total score p=0.002, rs=-0.324); between SF36 physical functioning domain and all MGH-SFQ domains (sexual desire p<0.001, rs=0.346; arousal p=0.005, rs=0.288; orgasm p=0.01, rs=0.268; erection/lubrification p=0.026, rs=0.232; overall satisfaction p=0.034, rs=0.222; total score p=0.008, rs=0.277); between SF36 role physical domain and two MGH-SFQ domains (sexual desire p=0.01, rs=0.268; arousal p=0.011, rs=0.265); between SF36 bodily pain domain and three MGH-SFQ domains (sexual desire p=0.031, rs=0.225; arousal p=0.045, rs=0.209; orgasm p=0.043, rs=0.212) and between SF36 mental health domain and four MGH-SFQ domains (sexual desire p=0.02, rs=0.243; arousal p=0.009, rs=0.270; overall satisfaction p=0.006, rs=0.282; total score p=0.024, rs=0.236).
Conclusion: This study helps to elucidate the negative impact of rheumatic diseases on sexual health, particularly in fibromyalgia, in contrast to systemic diseases. Our results might have been weakened by the heterogenous sample size between disease groups, but the findings highlight the importance of incorporating sexual health assessments into patient-reported outcomes routinely collected in clinical practice to further improve the quality of medical care to rheumatic patients.
REFERENCES: [1] Pereira H. Psychometric validation of the Portuguese version of the Massachusetts General Hospital - Sexual Functioning Questionnaire. Rev Int Androl. 2018 Jul-Sep;16(3):102-106.
Clinical and demographic characteristics by disease group.
| N | Female (n,%) | Age, years
| Disease duration, months (median, min-max) | DAS28-ESR
| DAS28-CRP
| ASDAS-ESR (median, min-max, n) | ASDAS-CRP (median, min-max, n) | SLEDAI (median, min-max) | ESSDAI (median, min-max) | |
|---|---|---|---|---|---|---|---|---|---|---|
| RA | 27 | 20, 74.1 | 61, 24-81 | 120, 3-456 | 2.7 (1.38-4.16, 27) | 1.68 (1.15-3.47, 27) | ||||
| SpA | 34 | 20, 58.8 | 54, 24-77 | 90, 1-672 | 2.59 (1.73-4.68, 19) | 1.92 (1.19-3.55, 19) | 1.9 (0.66-4.4, 21) | 1.7 (0.6-4, 21) | ||
| SLE | 12 | 10, 83.3 | 48, 29-65 | 90, 12-288 | 2 (0-8) | 0, (0-0) | ||||
| SSc | 11 | 9, 81.8 | 71, 27-89 | 108, 6-276 | ||||||
| FM | 5 | 4, 66.7 | 62, 48-66 | 48, 12-96 | ||||||
| SD | 3 | 2, 71.3 | 66, 61-78 | 12, 6-192 |
FM – fibromyalgia; RA – rheumatoid arthritis; SLE – systemic lupus erythematosus; SpA – spondylarthritis; SS – Sjögren disease; SSc – systemic sclerosis.
MGH-SFQ scores by disease group.
| Sexual desire (median, min-max) | Arousal (median, min-max) | Orgasm (median, min-max) | Erection/lubrification (median, min-max) | Overall satisfaction
| Total score
| At least one MGH-SFQ response < 2 (n, %) | |
|---|---|---|---|---|---|---|---|
| RA | 3 (1-5) | 4 (1-5) | 4 (1-5) | 3 (1-6) | 4 (1-6) | 18 (5-27) | 9, 33.3 |
| SpA | 4 (1-7) | 3 (1-7) | 3.5 (1-7) | 3 (1-7) | 4 (1-7) | 16 (5-35) | 7, 20.6 |
| SLE | 3.5 (1-5) | 3.5 (1-7) | 3.5 (1-6) | 4.5 (1-7) | 3.5 (1-6) | 17.5 (5-29) | 2, 16.7 |
| SSc | 3 (1-6) | 3 (1-6) | 3 (1-6) | 3 (1-5) | 3 (1-6) | 15 (5-29) | 5, 45.5 |
| FM | 1 (1-5) | 1 (1-4) | 1 (1-4) | 3 (1-4) | 1 (1-4) | 8 (5-21) | 4, 80.0 |
| SD | 3 (2-5) | 5 (4-5) | 5 (3-5) | 4 (3-5) | 4 (3-5) | 20 (16-25) | 0, 0 |
| Total | 3 (1-7) | 3 (1-7) | 3.5 (1-7) | 3 (1-7) | 4 (1-7) | 16 (1-7) | 27, 29.3 |
FM – fibromyalgia; RA – rheumatoid arthritis; SLE – systemic lupus erythematosus; SpA – spondylarthritis; SS – Sjögren disease; SSc – systemic sclerosis.
Acknowledgements: NIL.
Disclosure of Interests: None declared.
© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (