Sexual health in patients with rheumatoid arthritis and the association between physical fitness and sexual function: a cross-sectional study

Thomas Ernst Dorner,Ludwig Erlacher,Carolin Berner,Igor Grabovac,Sandra Haider,Karl Heinrich Fenzl,Thomas Lamprecht

doi:10.1007/s00296-018-4023-3

Thomas Ernst Dorner, Ludwig Erlacher + Show 5 more

Open Access

https://doi.org/10.1007/s00296-018-4023-3

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Abstract

The aim of this study was to examine sexual health in patients with rheumatoid arthritis (RA), and to analyse factors associated with sexual health with a focus on physical fitness. One hundred RA patients aged between 18 and 65 years were included in a cross-sectional study. Handgrip strength and knee extensor strength were measured with a dynamometer, and physical performance with the Short Physical Performance Battery (SPPB). Fifty-four patients, mean age 47.8 (SD 10.6) years, 61% female, answered a questionnaire about sexual health. Fifty-seven percent reported, at least, sometimes having difficulty with sexual intercourse (27.8% due to joint stiffness, 24.1% due to fatigue, 18.5% due to pain). Handgrip strength and knee extensor strength significantly correlated with the desire to engage in sexual intercourse, frequency of sexual contact and satisfaction with overall sex life. The SPPB total score correlated with satisfaction with overall sex life, and the SPPB repeated chair stands test with the desire to have sexual intercourse and satisfaction with overall sex life. After adjusting for age, gender, disease activity, comorbidity, co-medication and pain intensity, the repeated chair stands test remained significantly associated with the frequency of sexual contact (0.53; 0.01–1.05) and with satisfaction with overall sex life (1.39; 0.28–2.51). The results of this study show that problems with sexual health are highly prevalent in patients with RA. The ability to rise from a chair is associated with sexual function, independent of disease activity and pain intensity.

Highlights

In patients with rheumatoid arthritis (RA), subjective measures such as quality of life and health satisfaction have been recognised as very important health outcomes [1]
Our findings showed that more than half of the respondents of patients with RA had problems with sexual intercourse
The association between physical fitness parameters and parameters of sexual health clearly weakened when adjusted for disease activity, pain intensity, comorbidities, and co-medication

Summary

Introduction

In patients with rheumatoid arthritis (RA), subjective measures such as quality of life and health satisfaction have been recognised as very important health outcomes [1]. Sexual health is one of the strongest determinants of general health and quality of life [2], especially in patients affected by diseases associated with chronic pain [3]. Rheumatology International (2018) 38:1103–1114 function, such as desire, arousal, lubrication, orgasm and satisfaction, are often affected [7], while male RA patients often suffer from impaired sexual desire [9] and erectile dysfunction [10]. Factors that have been found to explain the impairment in sexual health in RA patients include pain intensity, disease activity, physical capacity and disability, joint stiffness, fatigue, mental conditions and the use of certain drugs [4, 11, 12]. Co-morbidities such as diabetes mellitus or depression, as well as treatment with medication such as antihypertensives, beta blockers or psychoactive substances can cause sexual dysfunction [13]

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