SEXUAL DYSFUNCTION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

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Abstract INTRODUCTION Inflammatory bowel disease (IBD) is likely to have an impact on sexual function because of its symptoms like diarrhea, fatigue and abdominal pain. The impact of the disease on sexuality and intimacy is one of the main concerns of IBD patients but there is still limited data on sexual (SD) and erectile dysfunction (ED) and its determinants in IBD. AIM OF THE STUDY This study aimed to evaluate sexual function and search for predictors of sexual dysfunction among patients with IBD during biological treatment. METHODS This was a prospective, one center study enrolled a cohort of 135 patients with Crohn’s disease (CD) and ulcerative colitis (UC) treated with biological treatment on the basis of the same inclusion criteria (CDAI>300 for CD, Total Mayo score>6 for CU). All IBD patients were invited to fill an anonymous validated questionnaire on their sexual function: Female Sexual Function Index (FSFI) or International Index of Erectile Function-5 (IIEF-5) and one question about how bowel problem limited sexual activity during the last 2 weeks from Inflammatory Bowel Disease Questionnaire (IBDQ). RESULTS Both groups of patients (CD and CU) considered for sexual function were treated with anti -TNF alfa agents. GKS were more frequent among females (24/68, 35%) than males (12/67, 18%), p = 0.037. Comorbidities index was also higher in females (31/68, 46% vs. 17/67, 25%), p = 0.023. In the entire study group SD occurred in 43,7% of patients, in comparable value of men and women (p =0,536). We didn’t demonstrate a relationship between the duration of IBD, taken drugs (GKS, immunosuppressants) and calprotectin levels and the results of the FSFI and IIEF-5 questionnaires. Self-assessment of limitation by disease (IBDQ) was significantly worse for females, than for men p < 0.001. There was a significant correlation between self-assessment of limitation by disease and IIEF-5 (p<0.001) and FSFI (p<0.001) scores in CU and CD patients. CONCLUSIONS According to our study SD and ED were mainly associated with psychological factors, the severity of the disease had no effect on them. The type of medication used to treat the underlying disease has no impact on the development of sexual dysfunction.