Sexual function in uncircumcised women with fibromyalgia: A controlled, cross-sectional, single-center study

Document Type : Original Article


1 Andrology department, Faculty of Medicine, Beni-Suef University

2 Rheumatology and Rehabilitation, Faculty of Medicine, Beni-Suef University, Beni-Suef, Cairo, Egypt

3 Ministry of Health and Population, Cairo, Egypt


Background: Fibromyalgia (FM) is a non-articulate rheumatic syndrome characterized by chronic musculoskeletal pain.
Objective: The aim was to determine the rate of sexual dysfunction in uncircumcised women with FM and to appraise factors associated with sexual dysfunction in affected women.
Patients and Methods: A total of 50 drug-naive uncircumcised women with FM and 50 pain-free matched controls were compared regarding the scores of Arabic female sexual function index and hospital anxiety and depression subscales (HADS-A and HADS-D). The affected women were evaluated for tender point count (TPC), pain level on a visual analog scale (VAS), and FM related difficulties via Fibromyalgia Impact Questionnaire (FIQ). Moreover, the partners of patients and controls were evaluated by the 5-item international index of erectile function (IIEF-5).
Results: The mean age of patients was 30.42±4.99 years and controls was 31.4±5.35 years, which was insignificantly different (P=0.345). Overall, 68% of patients and 16% controls displayed abnormal FSFI total scores (P<0.001). FSFI overall and domain scores were significantly lower among patients than controls (P<0.001). HADS-A and HADS-D scores were significantly higher among patients (11.6±4.68 and 11.46±4.96, respectively) than controls (5±2.64 and 2.26±1.68, respectively; P<0.001). IIEF-5 scores were significantly higher among partners of controls (22.48±1.42) compared with those of patients (19.78±2.33, P<0.001). FSFI showed significant (P<0.001) negative correlations with HADS-A, HADS-D, FIQ, VAS, TPC, and duration of disease and significant (P<0.001) positive correlations with frequency of intercourse and IIEF-5. Regression analysis revealed that anxiety, pain severity, and frequency of intercourse were the independent factors associated with sexual impairment in FM (95% confidence interval lower -1.117, -2.374, and 1.185 and upper -0.455, -1.040, and 4.366, and P<0.001, <0.001, and 0.001, respectively).
Conclusion: FM could disturb all dimensions of female sexuality. The relatively high frequency of sexual impairment reported here (68%) was associated with anxiety, pain severity, and frequency of intercourse.