Sexual Dysfunction in Perianal Crohnʼs Disease

Abstract

Purpose: Crohn's disease (CD) typically presents in adolescence or young adulthood, and is characterized by a chronic disease course with intermittent exacerbations of symptoms followed by periods of remission. Perianal complications are estimated to affect 35-45% of patients with CD. Our objective is to investigate an association between sexual dysfunction in patients with perianal CD. Methods: A pilot survey study was conducted using the Female Sexual Function Index (FSFI) and the Colitis Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Informed consent was obtained from all participants. Participants were identified by diagnosis code and gender. Chart review was used to identify patients with perianal CD; CD patients without perianal involvement constituted the control group. Retrospective chart review was done on all patients who returned the surveys to obtain demographic and disease activity information. Results: Eighty-five patients with perianal CD and 150 CD patients without perianal involvement were identified. The response rates were 12% and 7.3%, respectively. Both groups were similar in age, duration of disease, and had comparable SIBDQ scores. Of the 10 perianal CD respondents, five reported no attempts at vaginal penetration within the last 4 weeks, and two reported no sexual activity (defined caressing, foreplay, masturbation, and vaginal intercourse) in the last 2 weeks preceding the survey. The total FSFI score in the perianal CD patients was lower (23.6) compared to the control group (25.7), suggestive that patients with perianal CD may have a higher level of sexual dysfunction, but this was not statistically significant (p=0.58). Both groups have lower FSFI scores than normal subjects without CD, whose total FSFI score is typically 30. Conclusion: Women with CD report low levels of sexual intercourse and dissatisfaction with level of sexual desire. Survey results suggest that women with perianal CD may have a greater degree of sexual dysfunction than CD patients without perianal involvement; however, further larger scale studies are needed to determine if significant changes in sexual dysfunction exist.