The sexual problems of 50 women with Crohn’s disease, of whom 45 had a stable relationship, were investigated by structured interview and compared with age-matched controls. Twenty-four percent patients had either infrequent or no intercourse compared with 4% of controls (χ2 = 8.3, p < 0.005). However, amongst patients and controls who were sexually active, the frequency of intercourse was similar. Reasons for sexual inactivity included abdominal pain (24%), diarrhoea (20%) and fear of faecal incontinence (14%). Dyspareunia was common in patients (χ2 = 6.5, p < 0.01) and this was irrespective of the site of disease (large vs. small bowel χ2 = 0.85, NS). Women with perianal disease and fistulae were more likely to have dyspareunia than women with neither (χ2 = 4.2, p < 0.05), although this was not so for less extensive involvement with only perianal disease (χ2 = 2.8, NS) or fistulae (χ2 = 0.8, NS). Vaginal candidiasis was more common in patients (χ2 = 5.8, p < 0.02), and on occasions this may have contributed to dyspareunia. Women with Crohn’s disease experience sexual problems much more than healthy controls and they need support, sympathetic investigation and management.
The aims of the study were to ascertain whether patients have similar a fertility rate to the background population in Leicestershire and whether they have a similar rate of congenital malformations compared to the background population in Leicestershire. Over 1400 patients were invided to participate with an overall response rate of 81% after three successive mailings. The response rate was similar for both sexes and between the disease groups. The crude infertility rate for the group was 21%. The mean number of children for the whole group was 1.7 +/- 1.3 but both men and women with Crohn's disease had significantly less children than would be expected, (men with Crohn's disease 1.5, women with Crohn's disease 1.2). There were 39 children (2% of overall births) with congenital abnormalities reported by patients with inflammatory bowel disease and in 29 cases the parents reported taking sulphasalazine (Table 3). Although this figure compares well with the 1.8% reported congenital abnormality rate for Leicestershire within the patient group in this study congenital malformations were significantly related to sulphasalazine use, z = 4.3, P < 0.0001. In conclusion sulphasalazine not only as causes morphological abnormalities in spermatozoa but may increase the chances of having congenitally abnormal offspring amongst men with IBD. The effects of other 5-aminosalacylic acids have yet to be studied in detail.
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