Background: Sexual dysfunction (SD) has been negatively associated with quality of life and disease severity in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Previous studies have shown its prevalence ranges from 36% to 70% and may be influenced by additional factors such as fatigue, depression, and anxiety. [1] Despite its impact on quality of life, there seems to still exist a ‘two-way taboo’ [2], as sexual health is still not regularly addressed in routine rheumatologic evaluations.

Objectives: To evaluate how patients perceive their sexual health and determine the prevalence of sexual dysfunction in patients with RA and SLE.

Methods: A cross-sectional study in an outpatient rheumatology clinic was performed from August 2022 to April 2023. Patients ≥ 18 years old with a diagnosis of RA or SLE were included. We used The Sexual Health Perception Survey (SHEPS), a non-validated scale implemented in our institution to evaluate the patient’s perception of their sexuality. The sexual health assessment was performed with the Arizona Sexual Experiences Scale (ASEX) and only the responses of patients with an active sexual life were evaluated. The Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F) evaluated fatigue over the last 7 days, and the Hospital Anxiety and Depression Scale (HADS) the risk of depression and/or anxiety.

Results: A total of 567 participants were evaluated through SHEPS, 445 (78.5%) patients with RA and 122 (21.5%) patients with SLE. Through the SHEPS we found 98.2% of the patients did not know their disease could affect their sexuality, and although 84.8% had never talked to their rheumatologist about it, over 65% said they were willing to. Table 1 contains the responses to SHEPS assessed by diagnosis. In the ASEX, we found that 67% of the patients with RA experienced SD, 87.3% were women with a median (IQR) age of 44 years (35-48). As for SLE, 60% of the patients experienced SD, 90.48% were women, with a median (IQR) age of 32 (25.50-39.50). (Table 2) In the ASEX, patients reported more difficulties with the level of sex drive, arousal, and ability to achieve orgasms. We found no statistical significance between groups for fatigue or any sociodemographic variables.

Conclusion: We found a high prevalence of sexual dysfunction, in similar percentages in patients with RA and SLE, however, we found no statistical significance in sociographic or clinical variables between groups. Most patients have not addressed these issues with their rheumatologists, but more than half are willing to.

REFERENCES: [1] Dorner, T., Berner, C., Haider, S., Grabovac, I., Lamprecht, T., Fenzl, K. H., & Erlacher, L. (2018). Sexual health in patients with rheumatoid arthritis and the association between physical fitness and sexual function: a cross-sectional study. Rheumatology International, 38(6), 1103-1114. https://doi.org/10.1007/s00296-018-4023-3 .

[2] Graugaard C. (2017). Sexuality as a health-promoting factor - theoretical and clinical considerations. Nature reviews. Urology, 14(10), 577–578. https://doi.org/10.1038/nrurol.2017.117 .

Table 2. Sociodemographic and clinical characteristics of patients with and without sexual dysfunction

Acknowledgements: NIL.

Disclosure of Interests: None declared.