Musculoskeletal Pain and Sexual Function in Women

Abstract

Introduction Sexual pain disorders refer to conditions of genital pain that interfere with intercourse. They often have a musculoskeletal component related to the pelvic floor and are included in the DSM-IV as sexual dysfunctions. Musculoskeletal pain (MP) that is not essentially genitally based often interferes with sex as well yet is not considered a distinct sexual dysfunction. MP is generally addressed by physiatrists, orthopedists, and rheumatologists who are not traditionally trained in sexual medicine, and therefore, the sexual concerns of women with MP often go unaddressed. Aim The purposes of this review article were to describe how MP is perceived in the literature as affecting sexual function, illustrate how specific MP conditions prevalent in women may affect sexual function, and offer recommendations for clinical practice. Methods PubMed and Medline searches were performed using the keywords “musculoskeletal pain and sex,”“lower back pain and sex,”“arthritis and sex,” and “fibromyalgia and sex”. Main Outcome Measure Review of the peer-reviewed literature. Results Most studies cite fatigue, medication, and relationship adjustment as affecting sexuality much as chronic illness does. While musculoskeletal contributors to genital sexual response and pain are considered relevant to sexual function, little is understood about how MP syndromes specifically affect sexual activity. Conclusion Lack of mobility and MP can restrict intercourse and limit sexual activity, and gender differences are noted in response to pain. Sexual and relationship counseling should be offered as a component of rehabilitative treatment. Physical therapists are uniquely qualified to provide treatment to address functional activities of daily living, including sexual intercourse, and offer advice for modifications in positioning.

Women's experiences of sexual health when living with Rheumatoid Arthritis - an explorative qualitative study

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Psychological Factors in Chronic Pelvic Pain in Women: Relevance and Application of the Fear-Avoidance Model of Pain

“…Sex therapists may be helpful in addressing low libido or arousal problems in addition to the effect of sexual dysfunction on intimate relationships. 15,72 Weijmar Schultz et al 73 advocated careful psychological assessment of women with CPP and recommended that psychotherapy be initiated first if signs of psychopathology are present.…”

Sexual Function in Females With Rheumatoid Arthritis: Relationship With Physical and Psychosocial States

“…Patients with RA experience different aspects of sexual problems such as difficulties in sexual performance and diminution of sexual desire, arousal, lubrication, orgasm and satisfaction, which are directly or indirectly caused by the disease. [3][4][5][6][7][8][9][10] The cause of sexual problems with RA is multifactorial due to chronic disease aspects such as disease activity, pain, reduced physical activities, fatigue, and poor sleep and psychiatric comorbidities such as depression, anxiety, poor self-esteem, and altered body image and rarely drugs used for treatment. 8,[11][12][13] Researches are needed to identify and understand the mechanisms of sexual problems in RA to determine different types of interventions to support a satisfactory quality of life for patients with RA.…”