Rates and correlates of sexual activity and impairment among women with systemic sclerosis

Objective To assess 1) the rates of sexual activity and impairment, 2) clinical correlates of sexual activity/impairment, and 3) common sources of pain during and after sex in a large sample of female patients with systemic sclerosis (SSc; scleroderma). Methods. We performed a cross-sectional multicenter study of female SSc patients from the Canadian Scleroderma Research Group Registry. Patients underwent medical examinations and clinical histories and were asked whether they had engaged in sexual activities with their partner in the past 4 weeks. Sexually active patients completed a 9-item version of the Female Sexual Function Index (FSFI) and items related to problems that may be linked to sexual dysfunction in SSc. Multivariate logistic regressions assessed independent predictors of activity/ inactivity and sexual dysfunction. Results. A total of 226 (41%) of 547 patients, including 215 (54%) of the 401 patients currently in relationships, reported having engaged in sexual activities with a partner in the past 4 weeks. Among 165 sexually active patients with complete data for all variables, 102 (62%) had FSFI total scores < 22.5, indicating impaired function. Seventeen percent of the patients were sexually active and not impaired. Independent predictors (P < 0.05) of sexual activity were younger age, fewer gastrointestinal symptoms, and less severe Raynaud's phenomenon symptoms. Sexual impairment was independently associated with older age, higher skin scores, and more severe breathing problems. Vaginal pain was 8 times more likely among women with impairment. Conclusion. Research is needed to compare the extent of activity and impairment in SSc compared to women without SSc and to develop interventions to address impaired sexual function in women with SSc.