Sexual function in women with chronic painful temporomandibular disorders: A biopsychosocial case-control study

Temporomandibular disorders (TMD) are associated with psychosocial impairment. Although pain has been linked to female sexual dysfunction, the relationship between painful TMD and sexual function remains unclear.

To compare sexual dysfunction between women with chronic painful TMD and controls without painful TMD and explore clinical and psychosocial factors.

This cross-sectional case-control study included 120 women with chronic painful TMD (n=74) or controls (n=46). Sexual function and satisfaction were assessed using the FSFI and FSSS. Instruments assessed psychosocial variables, functional limitation, and pain characteristics. Groups were compared using Welch's t-tests and chi-square tests, followed by age-adjusted and attenuation models.

Women with painful TMD had a higher unadjusted prevalence of risk of sexual dysfunction than controls (55.4% vs. 26.1%) and lower scores for pain, lubrication, orgasm, and satisfaction. The association with risk of sexual dysfunction remained statistically significant after minimal adjustment for age (OR=3.58; 95%CI: 1.59-8.03; p=.002). In exploratory attenuation models (mandibular functional limitation and pain catastrophizing), the associations with risk of sexual dysfunction (OR=2.59; 95%CI:0.92-7.27; p =.071) and FSFI total score (B = -4.17; 95%CI:-8.79 to 0.46; p=.077) were not statistically significant. Within the TMD group, greater mandibular functional limitation was exploratorily associated with poorer sexual function.

Women with painful TMD showed greater FSFI-defined risk and poorer sexual function than controls. This association persisted after age adjustment but was attenuated in exploratory models. Mandibular functional limitation was exploratorily associated with poorer sexual function.