Rheumatology Advance Access originally published online on August 19, 2009
Rheumatology 2009 48(10):1300-1303; doi:10.1093/rheumatology/kep240
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(Not) talking about sex: a systematic comparison of sexual impairment in women with systemic sclerosis and other chronic disease samples
1Department of Psychiatry, 2Division of Rheumatology, McGill University and Jewish General Hospital, Montreal, Quebec, Canada, 3Department of Medicine and 4Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Correspondence to: Brett D. Thombs, Jewish General Hospital, Institute of Community and Family Psychiatry, 4333 Cote Ste Catherine Road, Montreal, Quebec H3T 1E4, Canada. E-mail: brett.thombs{at}mcgill.ca
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Abstract |
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Objective. Sexual impairment in women with SSc has received little attention. The objective of this study was to compare levels of sexual impairment in women with SSc with samples of women with medical illnesses for which sexual impairment has been researched more extensively.
Methods. SSc patients completed the Sexual Relationships subscale of the Psychosocial Adjustment to Illness Scale—Self-Report (PAIS-SR). A systematic review was conducted to select comparison samples. Sexual Relationships subscale scores from SSc patients were compared with scores from comparison samples (breast or gynaecological cancer and HIV) using t-tests and Hedges's g to calculate effect sizes.
Results. Samples from 138 female SSc patients were analysed (28.3% diffuse; mean age 52.1 ± 12.3 years; mean time since diagnosis 9.0 ± 8.3 years). Women with dcSSc (6.1 ± 4.2) reported significantly greater sexual impairment (P < 0.05) than those with lcSSc (4.4 ± 4.2), three breast cancer samples (1.8 ± 0.1, 3.4 ± 3.9, 1.6 ± 0.6) and two samples of HIV-positive female patients (4.4 ± 3.8, 4.5 ± 3.9). Scores in dcSSc were similar to one sample of HIV-positive women (5.8 ± 4.1) and gynaecological cancer patients (7.3 ± 4.3). Scores in lcSSc were significantly higher than two breast cancer samples, similar to one breast cancer sample and two HIV-positive samples, and significantly lower (P < 0.05) than in one HIV sample and gynaecological cancer.
Conclusion. Women with SSc, particularly those with dcSSc, have high levels of sexual impairment compared with women with other chronic diseases, where sexual function has received greater attention. Further research is needed on sexual function among women with SSc.
KEY WORDS: Systemic sclerosis, Sexual impairment, Women's health, Systematic comparison
Submitted 14 May 2009;
revised version accepted 9 July 2009.
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