Sexual dysfunction in systemic sclerosis
Authors:
B. Heřmánková 1; M. Špiritović 1; M. Tomčík 2
Authors‘ workplace:
Katedra fyzioterapie, Fakulta tělesné výchovy a sportu UK, Praha
1; Revmatologický ústav a Revmatologická klinika 1. LF UK, Praha
2
Published in:
Čes. Revmatol., 27, 2019, No. 2, p. 65-77.
Category:
Review Article
Overview
Systemic sclerosis (SSc) is a chronic autoimmune disease that may affect all aspects of life including sexual function. Unfortunately, sexual dysfunction is a greatly neglected area of the quality of life of rheumatic patients and still taboo among both patients and health professionals. However, new scientific evidence suggests that sexual function disorders in SSc are characterized by high prevalence and are an important issue for both men and women. The etiology of sexual dysfunction in SSc is multifactorial and includes factors associated with both physical and psychological status. The most common manifestations in women with SSc are vaginal dryness, dyspareunia and vaginal tightness. Erectile dysfunction is a frequent but also often underestimated symptom in men with SSc. The prevalence of erectile dysfunction in patients with SSc ranged from 12% to 81% in different studies. The main psychological factors, that may affect sexuality, are fear, depression, and changes in the appearance of the face and body that usually leads to impaired self-esteem. This review provides a summary about the impact of systemic sclerosis on sexual functioning, diagnostic approaches and treatment options for sexual dysfunctions in men and women with this disease.
Keywords:
systemic sclerosis – sexual functioning – female sexual dysfunction – Erectile dysfunction
Sources
1. Frikha F, Masmoudi J, Saidi N, Bahloul Z. Sexual dysfunction in married women with systemic sclerosis. Pan Afr Med J 2014; 17: 82.
2. Impens AJ, Seibold JR. Vascular alterations and sexual function in systemic sclerosis. Int J Rheumatol 2010; 139020.
3. Saad SC, Behrendt AE. Scleroderma and sexuality. Journal of Sex Research 1996; 33(3): 215–220.
4. Knafo R, Thombs BD, Jewett L, Hudson M, Wigley F, Haythornthwaite JA. (Not) talking about sex: a systematic comparison of sexual impairment in women with systemic sclerosis and other chronic disease samples. Rheumatology 2009; 48(10): 1300–1303.
5. Jaeger VK, Walker UA. Erectile Dysfunction in Systemic Sclerosis. Current Rheumatology Reports 2016; 18(8): 49.
6. Carreira PE. A female scleroderma patient with sexual dysfunction. Case studies in systemic sclerosis. Springer 2011; 221–228.
7. Knafo R, Haythornthwaite JA, Heinberg L, Wigley FM, Thombs BD. The association of body image dissatisfaction and pain with reduced sexual function in women with systemic sclerosis. Rheumatology 2011; 50(6): 1125–1130.
8. Sanchez K, Denys P, Giuliano F, Palazzo C, Bérezné A, Abid H, et al. Systemic sclerosis: sexual dysfunction and lower urinary tract symptoms in 73 patients. Presse Med 2016; 45(4): e79–e89.
9. Schouffoer AA, van der Marel J, Ter Kuile MM, Weijenborg PT, Voskuyl A, Vliet Vlieland CW, et al. Impaired sexual function in women with systemic sclerosis: a cross-sectional study. Arthritis and Rheumatism 2009; 61(11): 1601–1608.
10. Maddali Bongi S, Del Rosso A, Mikhaylova S, Baccini M, Matucci Cerinic M. Sexual function in Italian women with systemic sclerosis is affected by disease-related and psychological concerns. J Rheumatol 2013; 40(10): 1697–1705.
11. Rosato E, Barbano B, Gigante A, Aversa A, Cianci R, Molinaro I, et al. Erectile dysfunction, endothelium dysfunction, and microvascular damage in patients with systemic sclerosis. J Sex Med 2013; 10(5): 1380–1388.
12. Hong P, Pope JE, Ouimet JM, Rullan E, Seibold JR. Erectile dysfunction associated with scleroderma: a case-control study of men with scleroderma and rheumatoid arthritis. J Rheumatol 2004; 31(3): 508–513.
13. Foocharoen C, Tyndall A, Hachulla E, Rosato E, Allanore Y, Farge-Bancel D, et al. Erectile dysfunction is frequent in systemic sclerosis and associated with severe disease: a study of the EULAR Scleroderma Trial and Research group. Arthritis Res Ther 2012; 14(1): R37.
14. Chen CH, Lin YC, Chiu LH, Chu YH, Ruan FF, Liu WM, et al. Female sexual dysfunction: definition, classification, and debates. Taiwan J Obstet Gynecol 2013; 52(1): 3–7.
15. Latif EZ, Diamond MP. Arriving at the diagnosis of female sexual dysfunction. Fertil Steril 2013; 100(4): 898–904.
16. Mimoun S, Wylie K. Female sexual dysfunctions: definitions and classification. Maturitas 2009; 63(2): 116–118.
17. Basson R, Berman J, Burnett A, Derogatis L, Ferguson D, Fourcroy J, et al. Report of the international consensus development conference on female sexual dysfunction: definitions and classifications. J Urol 2000;163(3): 888–893.
18. Basson R, Leiblum S, Brotto L, Derogatis L, Fourcroy J, Fugl-Meyer K, et al. Revised definitions of women’s sexual dysfunction. J Sex Med 2004; 1(1): 40–48.
19. Basson R, Leiblum S, Brotto L, Derogatis L, Fourcroy J, Fugl-Meyer K, et al. Definitions of women’s sexual dysfunction reconsidered: advocating expansion and revision. J Psychosom Obstet Gynaecol 2003; 24(4): 221–229.
20. Basson R. Women’s sexual function and dysfunction: current uncertainties, future directions. International Journal of Impotence Research 2008; 20(5): 466–478.
21. McCabe MP, Sharlip ID, Atalla E, Balon R, Fisher AD, Laumann E, et al. Definitions of sexual dysfunctions in women and men: a consensus statement from the fourth international consultation on Sex Med 2015. J Sex Med 2016; 13(2): 135–143.
22. Basson R, Wierman ME, van Lankveld J, Brotto L. Summary of the recommendations on sexual dysfunctions in women. J Sex Med 2010; 7(1 Pt 2): 314–326.
23. Basson R. Women’s sexual dysfunction: revised and expanded definitions. CMAJ 2005; 172(10): 1327–1333.
24. Reed GM, Drescher J, Krueger RB, Atalla E, Cochran SD, First MB, et al. Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations. World Psychiatry 2016; 15(3): 205–221.
25. Tristano AG. The impact of rheumatic diseases on sexual function. Rheumatology Int 2009; 29(8): 853–860.
26. Impens A, Rothman J, Schiopu E, Cole J, Dang J, Gendrano N, et al. Sexual activity and functioning in female scleroderma patients. Clin Exp Rheumatol 2009; 27(3): S38.
27. Saad SC, Pietrzykowski J, Lewis SS, Stepien AM, Latham VA, Messick S, et al. Vaginal lubrication in women with scleroderma and Sjogren’s syndrome. Sexuality and Disability 1999; 17(2): 103–113.
28. Bruni C, Raja J, Denton CP, Matucci-Cerinic M. The clinical relevance of sexual dysfunction in systemic sclerosis. Autoimmunity Reviews 2015; 14(12): 1111–1115.
29. Bhadauria S, Moser DK, Clements PJ, Singh RR, Lachenbruch PA, Pitkin RM, et al. Genital tract abnormalities and female sexual function impairment in systemic sclerosis. Am J Obstet Gynecol 1995; 172(2 Pt 1): 580–5807.
30. Sampaio-Barros PD, Samara AM, Marques Neto JF. Gynaecologic history in systemic sclerosis. Clin Rheumatol 2000; 19(3): 184–187.
31. Wylie K, Daines B, Jannini EA, Hallam–Jones R, Boul L, Wilson L, et al. Loss of sexual desire in the postmenopausal woman. J Sex Med 2007; 4(2): 395–405.
32. Rosen RC. Assessment of female sexual dysfunction: review of validated methods. Fertil Steril 2002; 77(Suppl 4): S89–93.
33. Brotto L, Atallah S, Johnson-Agbakwu C, Rosenbaum T, Abdo C, Byers ES, et al. Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med 2016; 13(4): 538–571.
34. Stephenson KR, Toorabally N, Lyons L, C MM. Further validation of the female sexual function index: specificity and associations with clinical interview data. J Sex Marital Ther 2016; 42(5): 448–461.
35. Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther 2005; 31(1): 1–20.
36. Raina R, Pahlajani G, Khan S, Gupta S, Agarwal A, Zippe CD. Female sexual dysfunction: classification, pathophysiology, and management. Fertil Steril 2007; 88(5): 1273–1284.
37. Basson R. Rethinking low sexual desire in women. BJOG 2002; 109(4): 357–363.
38. Buster JE. Managing female sexual dysfunction. Fertil Steril 2013; 100(4): 905–915.
39. Jacobsen PL, Mahableshwarkar AR, Palo WA, Chen Y, Dragheim M, Clayton AH. Treatment-emergent sexual dysfunction in randomized trials of vortioxetine for major depressive disorder or generalized anxiety disorder: a pooled analysis. CNS Spectr 2016; 21(5): 367–378.
40. Harsh V, Clayton AH. Sex differences in the treatment of sexual dysfunction. Curr Psychiatry Rep 2018; 20(3): 18.
41. Clayton AH, Pradko JF, Croft HA, Montano CB, Leadbetter RA, Bolden-Watson C, et al. Prevalence of sexual dysfunction among newer antidepressants. J Clin Psychiatry 2002; 63(4): 357–366.
42. Sherwin BB, Gelfand MM, Brender W. Androgen enhances sexual motivation in females: a prospective, crossover study of sex steroid administration in the surgical menopause. Psychosomatic Medicine 1985; 47(4): 339–351.
43. Portman DJ, Bachmann GA, Simon JA, Ospemifene Study GROUP. Ospemifene, a novel selective estrogen receptor modulator for treating dyspareunia associated with postmenopausal vulvar and vaginal atrophy. Menopause 2013; 20(6): 623–630.
44. Portman D, Palacios S, Nappi RE, Mueck AO. Ospemifene, a non-oestrogen selective oestrogen receptor modulator for the treatment of vaginal dryness associated with postmenopausal vulvar and vaginal atrophy: a randomised, placebo-controlled, phase III trial. Maturitas 2014; 78(2): 91–98.
45. Segraves RT, Clayton A, Croft H, Wolf A, Warnock J. Bupropion sustained release for the treatment of hypoactive sexual desire disorder in premenopausal women. J Clin Psychopharma 2004; 24(3): 339–342.
46. Vegunta S, Kling JM, Faubion SS. Sexual health matters: management of female sexual dysfunction. J Women Health 2016; 25(9): 952–954.
47. Kocher A, Adler S, Spichiger E. Skin and mucosa care in systemic sclerosis-patients’ and family caregivers’ experiences and expectations of a specific education programme: A qualitative study. Musculoskeletal Care 2013; 11(3): 168–178.
48. Rullo J, Faubion SS, Hartzell R, Goldstein S, Cohen D, Frohmader K, et al. Biopsychosocial management of female sexual dysfunction: a pilot study of patient perceptions from 2 multi-disciplinary clinics. Sex Med 2018; 6(3): 217–223.
49. Proietti M, Aversa A, Letizia C, Rossi C, Menghi G, Bruzziches R, et al. Erectile dysfunction in systemic sclerosis: effects of longterm inhibition of phosphodiesterase type-5 on erectile function and plasma endothelin-1 levels. J Rheumatol 2007; 34(8): 1712–1717.
50. Aversa A, Proietti M, Bruzziches R, Salsano F, Spera G. The penile vasculature in systemic sclerosis: A duplex ultrasound study. Sex Med 2006; 3(3): 554–558.
51. Lally EV, Jimenez SA. Erectile failure in systemic sclerosis. NEJM 1990; 322(19): 1398–1399.
52. Aversa A, Bruzziches R, Francomano D, Rosato E, Salsano F, Spera G. Penile involvement in systemic sclerosis: new diagnostic and therapeutic aspects. Int J Rheumatol 2010; 2010: 708067.
53. Rosen RC, Cappelleri JC, Gendrano N, 3rd. The International Index of Erectile Function (IIEF): a state-of-the-science review. Int J Impot Res 2002; 14(4): 226–244.
54. Merla A, Romani G, Tangherlini A, Di Romualdo S, Proiettii M, Rosato E, et al. Penile cutaneous temperature in systemic sclerosis: a thermal imaging study. Int J Immunopathol Pharmacol 2007; 20(1): 139–144.
55. Gupta BP, Murad MH, Clifton MM, Prokop L, Nehra A, Kopecky SL. The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis. Arch Inter Med 2011; 171(20): 1797–1803.
56. Wespes E, Eardley I, Giuliano F, Hatzichristou D, Hatzimouraditis K. Guidelines on Male Sexual Dysfunction: Erectile dysfunction and premature ejaculation. Eur Urol 2013. 2013.
57. Hatzimouratidis K, Amar E, Eardley I, Giuliano F, Hatzichristou D, Montorsi F, et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol 2010; 57(5): 804–814.
58. Li P, Shen YJ, Liu TQ, Ma M, Zhang SJ, Wang YX, et al. Vacuum therapy for erectile dysfunction that fails to respond to PDE-5i: report of 70 cases. Zhonghua nan ke xue – National journal of andrology. 2013; 19(3): 236–240.
59. Walker UA, Tyndall A, Ruszat R. Erectile dysfunction in systemic sclerosis. Ann Rheum Dis 2009; 68(7): 1083–1085.
60. World Health Organization [online]. WHO: ©2018 [cit. 31. 03. 2019]. Dostupné z: https://icd.who.int/browse11/l-m/en#/http: //id.who.int/icd/entity/160690465
61. American Psychiatric Association. Diagnostický a statistický manuál duševních poruch. Editoři české verze: Raboch J, Hrdlička M, Mohr P, Pavlovská P, Ptáček R. Praha: Hogrefe-Testcentrum 2015. První české vydání ISBN 978-80-86471-52-5
62. Almeida PH, Castro Ferreira CD, Kurizky PS, Muniz LF, Mota LM. How the rheumatologist can guide the patient with rheumatoid arthritis on sexual function. Rev Bras Reumatol 2015; 55(5): 458–463.
63. Panush RS, Mihailescu GD, Gornisiewicz MT, Sutaria SH, Wallace DJ. Sex and arthritis. Bull Rheum Dis 2000; 49(7): 1.
64. Zvěřina J. Erektilní dysfunkce a mezioborový pohled na jejich léčbu. Prakt. Lékáren. 2013; 9(4–5): 161–164.
65. Turčan MP. Aktuální pohled na léčbu erektilní dysfunkce v ordinaci praktického lékaře. Med. Praxi 2015; 12(2): 83–88.
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Dermatology & STDs Paediatric rheumatology RheumatologyArticle was published in
Czech Rheumatology
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