Are the women with Sjögren's Syndrome satisfied with their sexual activity? / As mulheres com síndrome de Sjögren estão satisfeitas com sua atividade sexual?

ABSTRACT Objective: Females with Sjögren's Syndrome (SS) often experience vaginal dryness and dyspareunia, along with glandular and extraglandular symptoms. We aimed to evaluate sexual function and life quality in women with SS. Methods: Forty-six premenopausal women with SS and 47 age-matched controls were studied. Age, duration of the disease, medications, and comorbid diseases were noted. Participants completed 36-Item Short Form Health Survey (SF-36) and Female Sexual Function Index (FSFI). Patients were asked about vaginal discharge and itching in the last month, and if they informed their rheumatologists about any sexual problems. Gynecologic examinations were performed and vaginal smears were taken on each participant. Results: The median total scores of FSFI were significantly lower in the SS group than the controls [17.12 (2.4-27.8) and 27.4 (16.9-36.0), respectively, p < 0.001]. In the SS group, 37 (80.4%) and in the control group 18 (38.3%) of patients were sexually dissatisfied (p < 0.001). Vaginal dryness and lubricant use were significantly increased in patients with SS compared to controls (p < 0.001). Life quality scores were significantly lower in patients with SS than the controls (p < 0.001). Vaginal dryness was negatively correlated with FSFI total (r = −0.312, p = 0.035) and subscores except desire and arousal. Physical functioning, role physical and role emotional scores were positively correlated with total FSFI scores (r = 0.449, p = 0.002, r = 0.371, p = 0.011, r = 0.299, p = 0.043, respectively). Conclusions: Women with SS experience less satisfaction with sexual activity, which can be affected by age, vaginal dryness, physical pain, and impaired function due to the disease. Therefore, rheumatologists should pay attention to these symptoms and management.

RESUMO Objetivo: As mulheres com síndrome de Sjögren (SS) muitas vezes experimentam secura vaginal e dispareunia, juntamente com sintomas glandulares e extraglandulares. Este estudo objetivou avaliar a função sexual e a qualidade de vida de mulheres com SS. Métodos: Estudaram-se 46 mulheres pré-menopáusicas com SS e 47 controles pareados por idade. Avaliaram-se a idade, a duração da doença, os medicamentos usados e as comorbidades. As participantes preencheram o questionário de qualidade de vida 36-Item Short Form Health Survey(SF-36) e o Female Sexual Function Index (FSFI). As pacientes foram perguntadas quanto à presença de corrimento e prurido vaginal no último mês e se haviam informado a seus reumatologistas sobre quaisquer problemas sexuais. Fizeram-se exames ginecológicos e esfregaços vaginais de todas as participantes. Resultados: A mediana do escore total do FSFI foi significativamente menor no grupo SS do que no grupo controle [17,12 (2,4 a 27,8) e 27,4 (16,9 a 36), respectivamente, p < 0,001]. Nos grupos SS e controle, 37 (80,4%) e 18 (38,3%) das pacientes estavam sexualmente insatisfeitas, respectivamente (p < 0,001). A presença de secura vaginal e o uso de lubrificantes foram significativamente mais frequentes em pacientes com SS em relação aos controles (p < 0,001). Os índices de qualidade de vida foram significativamente menores nas pacientes com SS do que nos controles (p < 0,001). A secura vaginal esteve negativamente correlacionada com o FSFI total (r = −0,312 p = 0,035) e com todos os seus subescores, exceto desejo e excitação. Os escores de capacidade funcional, aspecto físico e aspecto emocional se correlacionaram positivamente com a pontuação total do FSFI (r = 0,449, p = 0,002; r = 0,371, p = 0,011; r = 0,299, p = 0,043, respectivamente). Conclusões: As mulheres com SS têm menor satisfação com a atividade sexual, o que pode ser afetado pela idade, secura vaginal, dor física e função prejudicada em razão da doença. Portanto, os reumatologista devem prestar atenção a esses sintomas e seu tratamento.

Sexual dysfunction and dissatisfaction in chronic hepatitis C patients

Introduction The prevalence of sexual dysfunction (SD) and dissatisfaction with sexual life (DSL) in patients with chronic hepatitis C virus infection (CHC) was jointly investigated via a thorough psychopathological analysis, which included dimensions such as fatigue, impulsiveness, psychiatric comorbidity, health-related quality of life (HRQL) and sociodemographic and clinical characteristics. Methods Male and female CHC patients from an outpatient referral center were assessed using the Brief Fatigue Inventory, the Barrat Impulsiveness Scale, the Beck Depression Inventory (BDI), the Hospital Anxiety and Depression Scale, the Hamilton Anxiety Scale (HAM-A), and the World Health Organization Quality of Life Scale-Brief Version (WHOQOL-BREF). Structured psychiatric interviews were performed according to the Mini-International Neuropsychiatric Interview. SD was assessed based on specific items in the BDI (item 21) and the HAM-A (item 12). DSL was assessed based on a specific question in the WHOQOL-BREF (item 21). Multivariate analysis was performed according to an ordinal linear regression model in which SD and DSL were considered as outcome variables. Results SD was reported by 60 (57.1%) of the patients according to the results of the BDI and by 54 (51.4%) of the patients according to the results of the HAM-A. SD was associated with older age, female gender, viral genotype 2 or 3, interferon-α use, impulsiveness, depressive symptoms, antidepressant and benzodiazepine use, and lower HRQL. DSL was reported by 34 (32.4%) of the patients and was associated with depressive symptoms, anxiety symptoms, antidepressant use, and lower HRQL. Conclusions The prevalence of SD and DSL in CHC patients was high and was associated with factors, such as depressive symptoms and antidepressant use. Screening and managing these conditions represent significant steps toward improving medical assistance and the HRQL of CHC patients. .

The prevalence of female sexual dissatisfaction and the dominant risk factors that may impair sexual satisfaction in Malaysian women.

The study aims were to investigate the prevalence of sexual dissatisfaction and the potential risk factors. This was a cross-sectional study on women attending primary care setting in Malaysia over a period of March to June 2005, and used a non-probability sampling method. A validated questionnaire for sexual function was used. A total of 230 married women aged 21 – 62 years old participated in this study. The ressults show that the majority of the respondents were less than 45 years old, predominantly Malays, and with higher academic achievement. We noted that 52.2% (120/230) study subjects had sexual dissatisfaction. Race, salary, education level, medical problems, dysmenorrhea, and menacrhe were likely not correlated with sexual dissatisfaction. The dominant risk factor related to sexual dissatisfaction was age of husband. In additional, sexual dissatisfaction was moderately (P = 0.077) related to sexual per month. The subjects who had their husbands aged 43-75 years compared with 24-42 years had 68% increased risk to experience sexual dissatisfaction [adjusted relative risk (RRa = 1.68; 95% confidence interval (CI) = 1.15 - 2.44]. In term of sexual frequency per month, those who had 1-3 times per month than 4-5 times per month had two-fold increased risk to experience sexual dissatisfaction (RRa = 2.03; 95% CI = 0.93-4.42; p = 0.077). In conclusion, the prevalence of sexual dissatisfaction was very high in Malaysian primary care population and it was strongly associated with women who married to an older husband and with infrequent sexual activity.