Sexual Dysfunction in Systemic Autoimmune Rheumatic Diseases: Prevalence, Impact, and Management Strategies

Area of Science:

• Rheumatology
• Sexual Medicine
• Quality of Life Research

Background:

• Systemic autoimmune rheumatic diseases (SARDs) significantly impair patients' quality of life, particularly sexual health.
• Sexual dysfunction (SD) is often overlooked in clinical settings despite its profound impact.
• Contributing factors to SD in SARDs include pain, fatigue, joint stiffness, hormonal changes, and psychological distress.

Purpose of the Study:

• To review the prevalence, impact, and management strategies for SD in patients diagnosed with SARDs.
• To examine SD across specific conditions: Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA), Ankylosing Spondylitis (AS), Sjögren's disease (SjD), Systemic Sclerosis (SSc), and Fibromyalgia Syndrome (FMS).

Main Methods:

• A systematic literature review was performed using major scientific databases (PubMed, Web of Science, Scopus).
• Relevant studies reporting SD in SARDs were identified using specific MeSH terms.
• Sexual function was commonly assessed using validated instruments like the Female Sexual Function Index (FSFI) and International Index of Erectile Function (IIEF).

Main Results:

• SD prevalence in SARDs varies widely (30%-90%) based on disease type and gender.
• High rates of SD were reported in SLE (up to 90% in women), RA (30%-70%), AS (41%-58% erectile dysfunction in men), SjD (over 56% in women), SSc (80% erectile dysfunction in men), and FMS (63%).
• Key drivers of SD include chronic pain, depression, vaginal dryness, fibrosis, and psychological burden.

Conclusions:

• SD is a highly prevalent and under-addressed issue in patients with SARDs.
• Effective management necessitates a multidisciplinary strategy.
• Treatment should integrate pain control, psychological support, hormonal interventions, and patient education.