van Berlo Willy T M, van de Wiel Harry B M, Taal Erik, Rasker Johannes J, Weijmar Schultz Willibrord C M, van Rijswijk Martin H
Rutgers Nisso Groep, Utrecht, 3506 GA, The Netherlands.
Clin Rheumatol. 2007 Jan;26(1):30-8. doi: 10.1007/s10067-006-0216-3. Epub 2006 Mar 1.
The objective of this study is to compare men and women with rheumatoid arthritis (RA) to controls regarding sexual motivation, activity, satisfaction, and specific sexual problems, and to determine the correlation of physical aspects of the disease with sexual functioning. Questionnaire for screening sexual dysfunctions (QSD), self-constructed questionnaire on experienced distress with joints during sexual activities, arthritis impact measurements scales 2 (AIMS2), and the modified disease activity score 28 (DAS 28) were the methods used. RA patients were recruited from a registration base in three Dutch hospitals. Controls were age and sex matched healthy volunteers. A completed questionnaire was sent back by 271 patients (response 23%). Forty-seven men and 93 women were clinically examined to obtain the DAS 28. Male patients felt less sexual desire, and female patients masturbated and fantasized less than controls. Differences in satisfaction were not found. Male and female patients did not experience more sexual problems than controls. Among the women, correlations were predominantly found between age and sexual motivation and activities, among the men between physical health and sexual problems. Up to 41% of the men (4-41 depending on the joints), and up to 51% of the women (10-51 depending on the joints) have troubles with several joints during sexual activities. Medications influencing ejaculation in men correlated with distress with orgasm. Conclusions are that patients are less sexually active than controls and a considerable number of both male and female patients have trouble with their joints during sexual activities. However, patients do not differ from controls regarding sexual satisfaction. Physiological changes due to RA are apparently independent from those on psychological level. It is argued that sexual satisfaction also depends on personal and social factors. In men, physical health and disease activity are more related with sexual problems than in women.
本研究的目的是比较类风湿性关节炎（RA）患者与对照组在性动机、性活动、性满意度及特定性问题方面的差异，并确定该疾病的身体状况与性功能之间的相关性。采用了性功能障碍筛查问卷（QSD）、自行编制的关于性活动期间关节疼痛困扰的问卷、关节炎影响测量量表2（AIMS2）以及改良的28关节疾病活动评分（DAS 28）等方法。RA患者从荷兰三家医院的登记库中招募。对照组为年龄和性别匹配的健康志愿者。271名患者（回复率23%）寄回了完整问卷。对47名男性和93名女性进行了临床检查以获取DAS 28评分。男性患者性欲较低，女性患者自慰和性幻想比对照组少。未发现满意度存在差异。男性和女性患者并未比对照组经历更多性问题。在女性中，年龄与性动机和性活动之间主要存在相关性，在男性中，身体健康与性问题之间存在相关性。高达41%的男性（根据关节不同为4%-41%）以及高达51%的女性（根据关节不同为10%-51%）在性活动期间会因多个关节出现问题。影响男性射精的药物与性高潮困扰相关。结论是患者的性活动比对照组少，相当数量的男性和女性患者在性活动期间会因关节出现问题。然而，患者与对照组在性满意度方面并无差异。RA导致的生理变化显然独立于心理层面的变化。有人认为性满意度还取决于个人和社会因素。在男性中，身体健康和疾病活动与性问题的关联比女性更大。
