From Private Practice, Wels; Private Practice, Stockerau; Internal Medicine VI, Medical University of Innsbruck, Innsbruck; Specialist in Sexual Medicine, Private Practice, Vienna; Elisabethinen Hospital, Linz; Centre of Excellence in Medicine, Linz; Academic Research Unit, 2nd Department of Internal Medicine, Kepler University Hospital, Linz; State Hospital Freistadt, Freistadt; Kurzentrum Ludwigstorff, Bad Deutsch Altenburg; Paracelsus Private Medical University, Salzburg, Austria.
R. Puchner, MD, MSc, MBA, Rheumatology Private Practice, Wels; J. Sautner, MD, Rheumatology Private Practice, Stockerau; J. Gruber, MD, PhD, Internal Medicine VI, Medical University of Innsbruck; E. Bragagna, MD, Private Practice in Sexual Medicine, Vienna; A. Trenkler, MD, Elisabethinen Hospital; G. Lang, MD, State Hospital Freistadt; G. Eberl, MD, Kurzentrum Ludwigstorff; A. Alkin, BSc, Centre of Excellence in Medicine; H. Pieringer, MD, MBA, Academic Research Unit, 2nd Department of Internal Medicine, Kepler University Hospital, and Paracelsus Private Medical University.
J Rheumatol. 2019 Jan;46(1):19-26. doi: 10.3899/jrheum.171287. Epub 2018 Sep 1.
To evaluate the effect of rheumatoid arthritis (RA) on impairing women's sexuality regarding motivation, activity, and satisfaction, and to assess the correlation of disease-related physical impairment within sexual functioning.
An anonymous survey among women with RA and healthy controls (HC) using standardized questionnaires, predominantly the Changes in Sexual Functioning Questionnaire-short form (CSFQ-14). In addition, disease activity, depression, and disability were evaluated.
There were 319 questionnaires distributed to patients and 306 to HC. Of these, 235 patient questionnaires (73.7%) and 180 HC questionnaires (58.8%) were returned, of which 203 and 169 were completed, respectively. Of the patients with RA, 47.8% had a total CSFQ-14 score of ≤ 41, indicating female sexual dysfunction (FSD), as compared to 14.2% of HC (p < 0.0001). The median CSFQ-14 score was lower in patients with RA [42 points, interquartile range (IQR) 36-48] than in HC (49 points, IQR 44-54; p < 0.0001), resulting in an OR of 5.53 (95% CI 3.19-9.57; p < 0.0001). After adjustment for confounders, given a higher mean age of patients (55.2 ± 11.3 yrs) than HC (47.4 ± 11.8 yrs; p < 0.0001), the OR for FSD in patients with RA was still 3.04 (95% CI 1.61-5.75; p = 0.001). Neither the Health Assessment Questionnaire-Disability Index nor the Clinical Disease Activity Index was associated with FSD after adjustment.
FSD apparently is highly prevalent in female patients with RA, affects all subdomains of sexual function, and is most likely underestimated in daily clinical practice. Of note, FSD could not be linked to disability or RA disease activity.
评估类风湿关节炎（RA）对女性动机、活动和满意度方面的性行为的影响，并评估疾病相关的身体损伤与性功能之间的相关性。
使用标准化问卷对 RA 女性患者和健康对照者（HC）进行匿名调查，主要使用性功能变化问卷简表（CSFQ-14）。此外，还评估了疾病活动度、抑郁和残疾情况。
共向患者发放了 319 份问卷，向 HC 发放了 306 份。其中，235 份患者问卷（73.7%）和 306 份 HC 问卷被退回，分别有 203 份和 180 份完成。在 RA 患者中，47.8%的患者总 CSFQ-14 评分≤41，表明存在女性性功能障碍（FSD），而 HC 中这一比例为 14.2%（p<0.0001）。RA 患者的 CSFQ-14 中位数评分较低[42 分，四分位距（IQR）36-48]，低于 HC[49 分，IQR 44-54；p<0.0001]，OR 为 5.53（95%CI 3.19-9.57；p<0.0001）。调整混杂因素后，由于患者的平均年龄（55.2±11.3 岁）高于 HC（47.4±11.8 岁；p<0.0001），RA 患者发生 FSD 的 OR 仍为 3.04（95%CI 1.61-5.75；p=0.001）。调整后，健康评估问卷残疾指数和临床疾病活动指数均与 FSD 无关。
FSD 在 RA 女性患者中显然非常普遍，影响性功能的所有亚领域，且在日常临床实践中很可能被低估。值得注意的是，FSD 不能与残疾或 RA 疾病活动度相关联。
