Female sexual dysfunction in anti-synthetase syndrome

Sexual dysfunction has not been investigated in women with anti-synthetase syndrome. The aim of this study was to determine the prevalence of sexual dysfunction in women with anti-synthetase syndrome compared with healthy controls (CTR), to evaluate associated clinical factors, and to assess the effect of cognitive behavioral therapy on sexual function and related outcomes.

This single-center study included a cross-sectional evaluation conducted between March and August 2023 and a prospective interventional phase. Thirty-three women with anti-synthetase syndrome and 31 CTR were included. Sexual function, sexual distress, quality of life, fatigue, depression, body image, physical activity, and disease-related parameters were assessed using validated questionnaires. Multivariate logistic regression was used to identify factors independently associated with sexual dysfunction. Patients with anti-synthetase syndrome and sexual dysfunction were invited to participate in group-based cognitive behavioral therapy, with up to 90 days' follow-up.

Groups were comparable with respect to age and marital status. Sexual dysfunction prevalence was significantly higher in the anti-synthetase syndrome group than in CTR (81.8 vs. 51.6%; p=0.016). Anti-synthetase syndrome was independently associated with sexual dysfunction (OR 4.11; 95%CI 1.20-15.78). Within the anti-synthetase syndrome cohort, patients with and without sexual dysfunction were similar across most variables, except for prednisone use, which occurred only in patients with sexual dysfunction. Six patients completed cognitive behavioral therapy, showing improvements in sexual distress, sexual function-particularly arousal-and fatigue at 90 days.

Sexual dysfunction is highly prevalent in women with anti-synthetase syndrome and appears intrinsically associated with the disease. Cognitive behavioral therapy represents a promising non-pharmacological strategy to improve sexual function, distress, and fatigue in this population.