Sexual dysfunction linked to psychological factors, but not IBD severity

In patients with inflammatory bowel disease (IBD), erectile and sexual dysfunction (SD) are significantly associated with psychological factors, but IBD severity appears to have no impact on such conditions, suggests a recent study. Likewise, the type of medication used to treat the underlying disease has no influence on SD development.

In this prospective single-centre study, the authors assessed sexual function and searched for predictors of SD among IBD patients during biological treatment. Some 135 patients with Crohn’s disease and ulcerative colitis on biologics were enrolled based on the following criteria: Crohn’s Disease Activity Index >300 and total Mayo score >6.

IBD patients were asked to complete an anonymous validated questionnaire on their sexual function: Female Sexual Function Index (FSFI) or International Index of Erectile Function-5 (IIEF-5) and one question about how bowel problem limited sexual activity during the last 2 weeks from Inflammatory Bowel Disease Questionnaire (IBDQ).

Patients in both Crohn’s disease and ulcerative colitis groups considered for sexual function received antitumour necrosis factor alpha agents. More women used glucocorticosteroids than did men (35 percent vs 18 percent; p=0.037). The comorbidity index was also higher in females (46 percent vs 25 percent; p=0.023).

Of the patients, 43.7 percent experienced SD, with similar rates between men and women (p=0.536). The results of the FSFI and IIEF-5 questionnaires were not associated with the duration of IBD, medications used (ie, glucocorticosteroids and immunosuppressants), and calprotectin levels.

Self-assessment of limitation by disease using IBDQ turned out to be much worse for women than men (p<0.001). In addition, self-assessment of limitation by disease was significantly associated with IIEF-5 (p<0.001) and FSFI scores (p<0.001) in patients with Crohn’s disease or ulcerative colitis.