POS0846\u2005SEXUAL FUNCTION IS IMPAIRED IN WOMEN WITH SYSTEMIC SCLEROSIS COMPARED TO HEALTHY CONTROLS

Abstract

Systemic sclerosis (SSc) is a multisystem, connective tissue disorder characterized by fibrosis of the skin and internal organ involvement, which can influence all aspects of life, including sexual life.This study aimed to compare sexual function in patients with SSc to age-/sex-matched healthy controls (HC) and determine the potential impact of clinical features on sexual function.In total, 90 women with SSc (mean age: 49.1, disease duration: 6.1 years, lcSSc/dcSSc: 62/28, mRSS: 9.3, ESSG activity index: 2.1), who fulfilled the ACR/EULAR 2013 criteria, and 90 healthy controls (mean age: 49.1) without rheumatic diseases filled in 12 well-established and validated questionnaires assessing sexual function (FSFI, BISF-W, SFQ-28, SQoL-F), pelvic floor function (PISQ-12, PFIQ-7), fatigue (FIS, Fatigue Impact Scale), physical activity (HAP, Human Activity Profile), disability (HAQ, Health Assessment Questionnaire), depression (BDI-II, Beck’s Depression Inventory-II) and quality of life (SF-36, Medical outcomes study Short Form 36 – PCS, Physical Component Summary; MCS, Mental Component Summary). A routine laboratory testing was performed. Data are presented as median (IQR).Patients with SSc reported significantly greater prevalence and severity of sexual dysfunction (FSFI, BISF-W, SFQ28 – in all subscales as well as total scores), worse sexual quality of life (SQoL-F) and pelvic floor dysfunction (PISQ-12, PFIQ-7) compared to HC (table 1). The prevalence of sexual dysfunction in patients with SSc according to the FSFI cut-off score was 77%. Worse scores in SSc patients were associated with longer disease duration [BISF-W-total (r=-0.243,p=0.026), FSFI-lubrication (r=-0.229,p=0.035)], higher disease activity [ESSG activity index: BISF-W-total (r=-0.291,p=0.010), FSFI-arousal (r=-0.299,p=0.007)], increased inflammation [CRP: BISF-W-receptivity/initiation (r=-0.301,p=0.007)], more pronounced fatigue [FIS-total: BISF-W-total (r=-0.412,p<0.0001)], more severe depression [BDI-II: FSFI-total (r=-0.506,p<0.0001), SQoL-F (r=-0.369, p<0.0001)], worse functional disability [HAQ: FSFI-total (r=-0.394,p<0.0001)], reduced physical activity [HAP: FSFI-total (r=0.535,p<0.0001)], and decreased overall quality of life [SF-36 PCS: FSFI-total (r=0.428,p<0.0001), SF-36 MCS: SQoL-F (r=0.472, p<0.0001)].Women with SSc reported significantly impaired sexual function and pelvic floor function compared to age-/sex-matched healthy controls. Worse scores in SSc were associated with disease-related features.Table 1.Sexual function and pelvic floor function in women with SSc and healthy controlsQuestionnaire: score range (meaning)SSc (n=90)HC (n=90)p-valueFSFI: Female sexual function index: 2 (worst) - 36 (best)19.4 (3.9-26.8)30.1 (23.1-32.9)p<0.0001BISF-W: Brief Index of Sexual Function for Women: -16 (worst) - 75 (best)14.3 (2.1-35.1)38.2 (19.3-46.2)p<0.0001SQoL-F: Sexual Quality of Life Questionnaire-Female: 0 (worst) - 100 (best)61.1 (34.4-81.1)91.1 (70.0-96.7)p<0.0001PISQ-12: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form: 0 (best) - 48 (worst)13.0 (9.0-17.0)7.0 (5.0-12.0)p<0.0001PFIQ-7: Pelvic Floor Distress Inventory Questionnaire: 0 (best) - 300 (worst)9.5 (0.0-48.8)0.0 (0.0-8.3)p<0.0001SFQ-28: Sexual Functioning Questionnaire-28 desire: 5 (worst) - 31 (best)17.0 (12.0-20.0)21.0 (17.0-23.0)p<0.0001SFQ-28 arousal sensation: 4 (worst) - 20 (best)10.0 (8.0-13.0)12.0 (9.0-15.0)p=0.0031SFQ-28 arousal lubrication: 2 (worst) - 10 (best)5.0 (4.0-7.0)8.0 (5.2-9.0)p<0.0001SFQ-28 arousal cognitive: 2 (worst) - 10 (best)5.0 (4.0-6.0)7.0 (5.0-8.0)p<0.0001SFQ-28 orgasm: 1 (worst) - 15 (best)10.0 (6.5-12.0)12.0 (10.0-13.0)p<0.0001SFQ-28 pain: 2 (worst) - 15 (best)12.0 (9.5-15.0)15.0 (13.0-15.0)p<0.0001SFQ-28 enjoyment: 6 (worst) - 30 (best)19.0 (12.5-24.0)24.0 (20.0-25.8)p<0.0001SFQ-28 partner: 2 (worst) - 10 (best)9.0 (8.0-10.0)10. (9.0-10.0)p=0.0182Supported by MHCR 023728, GA UK 1578119, and SVV 260373.None declared