Sexual problems in male ankylosing spondylitis patients: relationship with functionality, disease activity, quality of life, and emotional status

Abstract

This study has focused on sexual problems of male ankylosing spondylitis (AS) patients. Initially, patients' perceptions about the effects of disease on sexual intercourse were assessed. Secondly, we investigated the factors that relate to the disease and affect sexual intercourse negatively. Thirdly, we compared data from the patients whose sexual intercourse were affected negatively with of those whose sexual intercourse were unaffected. This is a cross-sectional and double-centered study. A total of 53 married or sexually active male patients, who were certainly diagnosed with AS according to modified New York criteria, were assessed. Twenty seven patients (50.94%) expressed that their sexual life was affected negatively by the AS in general (affected patients), and 26 patients (49.06%) expressed no negative effect (unaffected patients). Both affected and unaffected patients were compared with each other with regard to educational level, joint involvement, functionality, disease activity, quality of life, and depression status. Mean BASFI, BASDAI scores were worse in the affected group, and the difference was statistically significant (p = 0.012, p = 0.039, respectively). There were statistically significant differences between the groups with regard to lumbar column and hip involvement (p = 0.035, p = 0.021; respectively). The physical functioning, role limitations due to physical problems, vitality/energy/fatigue, general mental health, and general health perception subscale scores of SF-36 were worse in the affected group, and the differences were statistically significant (p = 0.027, p = 0.023, p = 0,013, p = 0.005, p = 0.045, respectively). Affected patients' Beck Depression Inventory scores were worse than those of unaffected patients, and the difference between the groups was statistically significant (p = 0.039). Sexual problems are common in AS patients and might usually be associated with joint involvement, decreased functionality, increased disease activity, decreased health quality, and depression. Therefore, while examining AS patients and managing their treatments, special attention must be given to all domains of life instead of only physical problems.

Sexual function in male patients with ankylosing spondylitis

“…8,9 Peker et al 25 reported significant correlation between the disease activity and sexual life parameters reported by AS patients. In this study there was a modest correlation between the disease activity and sexual dysfunction.…”

“…Sexual problems in AS may be associated with peripheral joint involvement, decreased functioning, exacerbations of the symptoms of the disease and poor health status. 9 Effects of AS on sexuality may have psychological origin. Anxiety, loss of esteem, grief and depression can impair sexual fulfillment.…”

Assessment of Sexual Functions in Male Patients with Ankylosing Spondylitis Compared with Healthy Controls

“…[2] The factors that are involved in the progress of sexual function consist of physiological, psychological, sociocultural, and sexual self-perception, any of which can limit the sexual functioning of an individual. [3] Chronic diseases are risk factors for ED, and they frequently affect sexual functions. Recently, sexuality and its related problems, which are often neglected by physicians or other health professionals, have been investigated in conjunction with different rheumatic diseases.…”

“…[9] However, some of the previous studies used a mixed, non-standard survey that included different questions about the impact of AS on sexual relationships and did not use validated questionnaires. [3,10,11] Only a few studies exist that have utilized validated questionnaires. [9,[12][13][14] However, each of these studies used a different validated scale, and the differences in their methods led to the controversial results.…”

Papel do fator de necrose tumoral (TNF-a) na fisiopatologia da disfunção erétil.

“…De fato, diversas situações clínicas que se manisfestam com níveis aumentados de TNF-α têm sido associadas com a DE em homens e disfunção sexual em mulheres, tais como: psoríase, 184 artrite psoriática, 185 artrite reumatoide, 186 espondilite anquilosante [187][188][189] e doença pulmonar obstrutiva crônica. 104 Pacientes com estas condições, em geral, apresentam diminuição da libido, frequência de coito, mudanças negativas no desempenho sexual e insatisfação geral relacionada com a função sexual.…”