Risk factors for sexual dysfunction in Egyptian patients with rheumatoid arthritis and its relation to disease activity

Aim of the workTo assess risk factors for sexual dysfunction in married rheumatoid arthritis (RA) patients.Patients and methods216 RA (187 females and 29 males) and 187 matched healthy controls were included. Sexual function in male was assessed by modified International Index of Erectile Function Questionnaire (IIEF questionnaire) including: erectile function, sexual desire (libido), orgasmic and ejaculatory problems. For females, in addition to questions about libido, orgasmic problems, frequency of sexual intercourse and dyspareunia were considered. Disease activity scores (DAS-28) and modified health assessment questionnaire (mHAQ) were calculated.ResultsThe mean age of the patients was 45.2 ± 12.1 years and disease duration was 8.2 ± 7.6 years. All sexual dysfunction parameters were significantly higher in RA than in the controls. Patients with sexual dysfunction were older (p = 0.008), illiterate (p = 0.04), diabetics (p = 0.004), hypercholesterolemics (p = 0.002), had high ESR (45.1 ± 21.6 mm/1st h) (p < 0.001), longer MS duration (39.3 ± 40.9 minutes) (p = 0.01), had high DAS28 (p < 0.001) and mHAQ (p = 0.004) and used higher doses of leflunomide (p = 0.01). Multivariate regression analysis revealed that the presence of DM (OR 5.1; 95%CI 1.3-19.4), hypertension (OR 3.5; 95%CI 1.9-6.1), hypercholesterolemia (OR 3.6; 95%CI 1.5-8.2), older age (⩾45 years) (OR 2.4; 95%CI 1.3-4.5) (p = 0.003), active RA patients were associated with a higher risk of sexual dysfunction (OR 2.7; 95%CI 1.09-6.5) (p = 0.03); OR increased to 5.6 (95%CI 2.7-11.8) in patients with severe disease activity.ConclusionDM, hypertension, hypercholesterolemia, older age and high disease activity in RA increase the risk of sexual dysfunction.