Assessment of Sexual Function and Attitudes in Female Patients With Functional Bowel Disorders

Abstract

Introduction: There is limited empirical consideration of the sexual health effects in pelvic floor disorders for women, especially impacting sexuality. Addressing sexual function domains affected by chronic constipation (CC) and fecal incontinence (FI) may improve a patient’s quality of life, relationships, and better prepare physicians to address social aspects of functional bowel disorders. Examine the relationships between CC, FI and sexual dysfunction related to patients’ attitude toward sharing their sexual health history in a medical setting. Methods: A sub-analysis of a cross-sectional study of 445 adult female patients in gynecology, urology, and gastroenterology clinics at a tertiary referral health system from January 2014 through June 2014. Sixty-five (77% female, mean age =43, and 66% white) women with CC or FI that were referred for anorectal manometry (ARM) were included. All questionnaires included demographics, questions about sexual health, and the female sexual function index (FSFI). An abnormal FSFI was defined as a cumulative score ≤26.55, with higher scores indicating better sexual function. Comparisons of sample proportions and function indices were performed using Pearson’s chi square test, independent t-tests, and generalized linear models. Results: Women undergoing ARM for CC or FI had a mean total FSFSI score of 13.16 vs. the general sample mean 18.30 (p=.003). The FSFI domain scores of ARM patients were significantly lower than the general sample for desire, arousal, lubrication, and satisfaction (Table 1). Patients with FI were significantly more likely than those with CC to provide their sexual health history by filling out a form (35% vs. 13.9%) as opposed to with their ob/gyn or urologist in person (40% vs. 52.8%) (p= 0.035).Table 1Conclusion: Sexual dysfunction was more common in women affected by CC and FI than the general sample of adult women in gynecology, urology and gastroenterology clinics. Results suggest that functional bowel disorders do not uniformly affect the sexual lives and attitudes of women. This should be taken into consideration during patient/physician interaction and medical treatment. Further investigation between the relationship between pelvic floor disorders and sexual dysfunction is warranted.