Sexual dysfunction in women in the reproductive age with rheumatoid arthritis: A case-control study

Document Type : Original Article


1 Department of Andrology, Faculty of Medicine, Cairo Universiy, Egypt

2 Department of Andrology, Faculty of Medicine, Beni-Suef University, Egypt

3 Department of Dermatology and Venereology, Fayoum General Hospital, Fayoum, Egypt

4 Lecturer of Andrology, Andrology Dept., Faculty of Medicine, Cairo University.


Introduction: Rheumatoid arthritis (RA) is a widespread disease that has a profound effect on the patient’s quality of life.
ِAim:The aim was to evaluate the rate of sexual dysfunction (SD) in women with RA and to assess the possible association between SD and disease activity, severity of morning stiffness, functional disability and psychological status.
Patients and Methods: A case-control study was conducted on 200 sexually active, women in the reproductive age. A total of 100 women with RA attending the rheumatology clinics of two reference hospitals in Upper Egypt and 100 arthritis-free age- and sex-matched healthy controls were compared regarding the scores of Arabic Female Sexual Function Index (ArFSFI) and Hospital anxiety and depression scale (HADS). Additionally, women with RA were evaluated via Health Assessment Questionnaire (HAQ) and Disease Activity Score (DAS-28).  Results: The mean ages of patients (35.96.4± years) and controls (34.45.4± years) were insignificantly different (P>0.05). Mean FSFI total and domain scores of patients were significantly lower than controls (P<0.001). Overall, 94% of patients and 30% of controls (P<0.001) reported SD. Among women with RA (n: 100), lower SF scores were reported among those with morning stiffness (n: 14, P<0.05). Women with RA who exhibited SD had higher levels of anxiety, depression, and disease activity (P<0.05) than those without SD. However, both subgroups were not different regarding HAQ.  Conclusion: The present study found an SD rate of 94% among sexually active women with RA. RA could have an extensively negative effect on all aspects of female sexuality, particularly on lubrication and orgasm dimensions. Moreover, SD in women with RA is significantly associated with disease activity, severity of morning stiffness, depression, and anxiety levels, but not with functional disability (HAQ).