Sexual dysfunction in women with systemic autoimmune rheumatic disorders: a systematic review and meta-analysis

Abstract

Objectives In women with systemic autoimmune rheumatic diseases (SARDs), female sexual dysfunction (SD) remains underestimated. We aimed to explore the prevalence and correlates of SD in females with SARDs. Methods We performed a systematic review and meta-analysis of studies assessing the prevalence of SD and the pooled Female Sexual Function Index (FSFI) scores in this setting (PROSPERO: CRD42021287346). We searched PubMed, Embase and CENTRAL databases and grey literature until February 2022. We evaluated the quality of the selected records using the Hoy Risk of Bias tool. A random-effects meta-analysis of proportions with the double arcsine transformation was conducted. Subgroup and sensitivity analyses, as well as meta-regression of important correlates, were conducted. Results We included 68 studies with 5457 females diagnosed with a SARD (mean age: 43.7 ± 12.9 years). The overall SD prevalence was 63% (95% confidence interval (CI): 56–69%, I2=94%) and the overall FSFI total score was 19.7 points (95%CI: 18.4–21, I2=97%). Including only sexually active females, the SD prevalence was estimated as 60% (95%CI: 53–67%, I2=88%), whereas the FSFI total score was 22 points (95%CI: 20.8–23.1, I2=93%). Across the different SARDs, women with Sjogren’s syndrome and systemic sclerosis reported the highest levels of SD (74%, 95%CI: 58–87%, I2=84% and 69%, 95%CI: 54–83%, I2=94%, respectively). Conclusion Sexual function in females with SARDs seems to be severely impaired, irrespective of the type of SARD. Screening and treatment of SD in females with SARDs should become an integral part of healthcare clinical practice.

Update zum Sjögren-Syndrom: Diagnostik & Therapie

“…Besonders belastend sind für die PatientInnen dabei die rezidivierenden Konjunktivitiden, welche bei 5 % der PatientInnen als Keratokonjunktivitis sicca auftreten und zu kornealen Ulzerationen (2 %) mit nachfolgenden Einschränkungen des Visus führen können [19]. Zudem sind Karies, Depression, Hyposomnie, sexuelle Dysfunktion, Small-Fiber-Neuropathie und Hyposmie typische und häufige Komorbiditäten [20][21][22]. Entsprechend ist der klinische Phänotyp der SjS vielfältig und individuell sehr unterschiedlich.…”

Sexual Dysfunction in Postural Orthostatic Tachycardia Syndrome (POTS): A Cross-Sectional, Case-Control Study

“…Given a high prevalence of comorbidity between POTS and EDS, there may also be increased rates of these gynecologic complications in POTS patients. Additionally, a systematic review revealed that 63% of women with systemic autoimmune rheumatic diseases, another common comorbidity in POTS, experience sexual dysfunction, which is particularly prevalent in patients with Sjogren's syndrome and systemic sclerosis [17].…”

Premature Ovarian Insufficiency in Systemic Sclerosis

“…Involvement of the musculoskeletal, pulmonary, cardiovascular, gastrointestinal systems, and, rarely, lower urinary tract in SSc has been demonstrated in many studies [7,8]. In addition, several studies have shown that SSc can cause sexual impairment by causing musculoskeletal pain, joint contractures, vaginal dryness and stenosis, decreased quality of life and physical function, and deterioration in psychological status such as depression [9][10][11][12]. However, research into premature ovarian senescence in these patients is scarce.…”