Difficulties with engaging in sex — including arousal, lubrication, orgasm, and satisfaction — are significant in women with primary Sjögren’s syndrome compared to healthy women, and sexual function decreases as disease duration increases, a study reports.
The findings, “Primary Sjögren’s Syndrome Adversely Affects the Female Sexual Function Assessed by the Female Sexual Function Index: A Case-Control Study,” were published in the journal Archives of Rheumatology.
Immune cells in primary Sjögren’s syndrome attack certain glands, leading to symptoms of dryness. The most common are dry eyes and dry mouth, but other symptoms, including vaginal dryness, may also appear.
Women with Sjögren’s often complain of painful sexual intercourse as a result of vaginal dryness, but their extent and how they affect overall sexual intimacy are rarely discussed with or by patients, particularly in traditional societies like Turkey, where this research took place.
To understand how primary Sjögren’s syndrome affects women’s sexual function and overall life quality, and to determine if these management strategies might help, researchers conducted a case-control study involving 31 patients and 27 healthy women.
Patients, ages 30 to 68 and with mean disease duration of 35.9 months, had been followed at the Cumhuriyet University Medical Faculty, in Sivas, between June 2014 and June 2015. Healthy women, 30 to 55, of the same ethnicity were selected among hospital staff. All had a sexual partner at the time of the analysis.
Investigators examined sexual function using the 19-item Female Sexual Function Index (FSFI), a questionnaire that evaluates six subdomains — arousal, desire, lubrication, orgasm, pain, and satisfaction.
The two groups were similar regarding education, smoking status, number of additional diseases, and number of postmenopausal women. The number of pregnancies and deliveries, however, was higher among women with Sjögren’s.
An analysis of clinical history showed that patients were more likely to have had a vaginal infection, and had higher rates of inflammation and atrophy in the cervix “most probably due to vaginal dryness,” the researchers wrote.
The sexual function questionnaire also showed lower scores in the patient group — suggestive of poorer sexual function — in all domains but desire. But desire was found to decrease significantly with longer disease duration, which was also seen for arousal, lubrication, orgasm, and satisfaction scores.
“In this case-control study, we showed that females with pSS [primary Sjögren’s syndrome] have significant sexual dysfunction in comparison to healthy females with varying severity depending on the duration of disease,” the researchers concluded.
Findings suggested that the management of women with Sjögren’s syndrome should include an assessment of sexual function and measures that maintain it at a satisfactory level, as “vaginal discomfort and pain may mostly contribute to sexual dysfunction in patients with pSS.”
“Considering the importance of sexual functionality in the overall health of females, both patients and physicians should be informed on the possibility of pSS-related female sexual dysfunction,” the investigators added.
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