POS0540 SEXUAL DYSFUNCTION IN MALE PATIENTS WITH RHEUMATIC DISEASES

Abstract

Background:Sexual health is an essential element of overall health and well-being. Rheumatic diseases may affect sexual functioning in many ways related to pain, fatigue, stiffness, functional impairment, depression, anxiety, negative body image, reduced libido, hormonal imbalance and drug treatment. However, these issues are rarely addressed in clinical practice.Objectives:The aim of this study was to evaluate sexual function in a cohort of men with rheumatic disease compared to healthy controls.Methods:This was an observational, single-center, cohort study conducted between august 2019 and march 2020 in the Rheumatology department of “Saint Mary” Clinical Hospital in Bucharest which included 120 men with ages between 18 and 60 years - 60 patients with rheumatic diseases and 60 healthy controls. The study tools were the Sexual Health Inventory for Men (SHIM) questionnaire and one questionnaire referring to personal data, history of the rheumatic disease, comorbidities, treatment and sexual impairment. Also, the disease activity was assessed using specific scores for each condition.Results:In this cohort of 60 patients, the mean age was 45.26 (7.8) years and the diagnoses wereankylosing spondylitis (AS) - 37%,psoriatic arthritis (PsA) - 18%, rheumatoid arthritis (RA) - 17%, systemic sclerosis (SS) - 15% and gout - 13%. More than half of the patients (62%) had active disease based on specific scores (ASDAS for AS, DAS28-CRP for RA, EScSG disease activity indices for SS, DAPSA for PsA). Regarding sexual life, this study showed a significant decrease in sexual life quality after rheumatic disease diagnosis(before diagnosis: 71,67% - satisfying and 16,67% - not satisfyingversus after diagnosis: 21,67% - satisfying and 68,33% - not satisfying). Most patients (90%) reported impairment of their sexual life after diagnosis. In terms of sexual dysfunction (SD), a significantly higher proportion of patients (40%) mentioned reduced libido compared to the control group (18,33%) (p=0.043). Also, 21,66% of the patients reported erectile dysfunction (ED) in comparison with only 8,33% in the control group (p=0.009). Most patients with AS, RA, PsA and gout had mild ED while most patients with SS presented with mild to moderate ED. Also, the SHIM score mean value was significantly lower in the study group (17,65)compared to the control group (20,15) (p=0.009). The importance of SD in this cohort is emphasized by the fact that only one patient conceived after rheumatic disease diagnosis. Concerning treatment, more than half of the patients (55%) reported no effect of the therapy on their sexual life while 38.33% mentioned that medication improved their sexual life and very few (7%) reported a worsening.Conclusion:This study revealed a higher prevalence of sexual dysfunction in male patients with rheumatic disease in comparison with healthy controls. Considering the importance of sexual and reproductive health, rheumatologists should approach this topic with their patients and offer them guidance.