Special Considerations for Women with IBD

Moleski, Stephanie; Choudhary, Cuckoo

doi:10.1016/j.gtc.2011.03.003

Cited by 22 publications

(11 citation statements)

References 47 publications

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“…The significant association between constipation history and FSD is corroborated by the close relationship between constipation itself and the incidence of rUTIs26. Some studies have suggested that the foecal flora acts as an optimal reservoir for the microbial strain that may subsequently recolonize the introitus and then the bladder, causing rUTIs2627.…”

Section: Discussionmentioning

confidence: 93%

Six Out of Ten Women with Recurrent Urinary Tract Infections Complain of Distressful Sexual Dysfunction – A Case-Control Study

Boeri¹,

Capogrosso²,

Ventimiglia³

et al. 2017

Sci Rep

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Uncomplicated recurrent urinary tract infections (rUTIs) are common among reproductive-aged women. We aimed to assess the prevalence and predictors of sexual dysfunction (FSD) in a cohort of women with rUTIs and compare their psychometric scores to those of matched controls. Data from 147 rUTIs women and 150 healthy controls were analysed. Participants completed the International Prostatic Symptoms Score (IPSS), the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (SDS). Descriptive statistics and logistic regression models tested prevalence and predictors of distressful FSD. Women with rUTIs had lower FSFI scores (p < 0.001) and a greater proportion of pathological FSFI (78.9% vs. 21.4%; p < 0.001) and SDS scores (77.8% vs. 21.4%; p < 0.001) than controls. Of rUTIs patients, 88 (60%), 77 (52.2%), and 75 (51.1%) reported pathological scores for FSFI-pain, lubrication and arousal, respectively; moreover, 64% had concomitant pathological FSFI and SDS scores. Age, IPSS severity, rUTIs, a history of ≥6 UTIs/year and a history of constipation were independent predictors of pathologic FSFI and SDS (all p ≤ 0.05). In conclusion, up to 80% of women with rUTIs showed pathologic FSFI and SDS scores, with 60% reporting scores suggestive of distressful FSD. Having ≥6 UTIs/year and a history of constipation independently predicted distressful FSD.

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Section: Discussionmentioning

confidence: 93%

Six Out of Ten Women with Recurrent Urinary Tract Infections Complain of Distressful Sexual Dysfunction – A Case-Control Study

Boeri¹,

Capogrosso²,

Ventimiglia³

et al. 2017

Sci Rep

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“…Women with IBD are cared for by gastroenterologists who prescribe medications for IBD management, but may not have the knowledge or comfort level to discuss contraceptive options [23]. In addition, communication between gastroenterologists and reproductive health providers may be patient-driven only, minimizing the ability to gain timely access to contraceptive counseling when a medication change occurs [24].…”

Section: Discussionmentioning

confidence: 99%

Contraceptive method selection by women with inflammatory bowel diseases: a cross-sectional survey

Gawron

Kasper

et al. 2014

Contraception

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Objective-Women with inflammatory bowel diseases (IBD) utilize contraception at a lower rate than the general population. We sought to identify factors associated with contraceptive use and selection of more effective methods in IBD patients at risk for unintended pregnancy.Study Design-An online survey was distributed to women with IBD in January 2013. Contraceptive methods were categorized by effectiveness and associations with use explored by demographics, disease characteristics, and reproductive goals.Results-162 respondents were analyzed: 62% had Crohn's disease and 38% ulcerative colitis. Mean age was 31 (range 20-45), 97% identified as White, and 53% were nulliparas. 74% were currently using IBD medications. A quarter of participants (23%) used no contraception, 17% used highly effective methods, 41% used short-term hormonal methods, and 19% chose barrier/ behavioral methods. Prior IBD-related surgery, biologic therapy use, and low education attainment were associated with no contraception use. Of contraceptive users, age, parity, insurance status, IBD surgery and prior immunomodulator use were associated with highly effective method selection.Conclusions-A quarter of women with IBD at-risk for pregnancy in this study population reported no contraceptive method use. Higher levels of IBD activity influence contraceptive use and method selection, which could guide future patient and provider educational interventions.Implications-Pregnancy planning is important for women with inflammatory bowel diseases to avoid adverse outcomes in a disease-poor state. Use of contraception assists in avoidance of

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“…We lacked data about the local hormonal milieu, which clearly emerged as a key factor in promoting urogynecologic and women's sexual health . In addition, this analysis lacked a careful evaluation of bowel function, with particular focus on the prevalence of constipation and the presence of typical irritable bowel syndrome . Finally, the study lacked psychometric evaluation of pain‐associated sexual distress.…”

Section: Discussionmentioning

confidence: 99%

Secondary Provoked Vestibulodynia in Sexually Active Women with Uncomplicated Recurrent Urinary Tract Infections

Salonia

Clementi

Graziottin

et al. 2013

The Journal of Sexual Medicine

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Introduction Uncomplicated recurrent urinary tract infections (rUTIs) associated with uropathogenic Escherichia coli (UPEC) are common among healthy, reproductive-aged women. Provoked vestibulodynia (PVD) is a major reason of sexual pain in premenopausal women. Aim The aim of this paper is to assess prevalence and predictors of secondary PVD in a cohort of Caucasian–European, heterosexual, sexually active, reproductive-aged women seeking medical help for rUTIs as their primary complaint. Methods Clinical and psychometric variables for 60 consecutive patients with rUTIs were considered. Patients were assessed with a thorough medical and sexual history, a number of psychometric instruments, and a specific physical examination. Urinalysis and self-collected urine cultures from the previous 12 months were also examined. Main Outcome Measure Descriptive statistics and logistic regression models were used to test the associations between secondary PVD and sociodemographic and clinical variables. Results Mean age was 34.2 years (median 33 years; range 21–42). Secondary PVD was found in 36 of 60 patients (60%). Women with PVD had a higher prevalence of urinary tract infections (UTIs) over the previous 12 months (χ2: 4.54; P =0.03) and suffered more frequently from UPEC-related rUTIs (χ2: 5.92; P =0.01) than those without PVD. Moreover, women with PVD showed significantly lower scores on Female Sexual Function Index domains (all P ≤0.01), as compared with PVD-negative women. UPEC-related rUTIs (odds ratio [OR]: 3.1; P =0.01), six or more UTIs over the previous 12 months (OR: 2.8; P =0.01), and treatment with three or more antibiotics throughout the same period (OR: 2.1; P =0.04) emerged as independent predictors of PVD. Conclusions Three of five Caucasian–European, heterosexual, sexually active women of reproductive age complaining of rUTIs as their primary disorder also suffer from secondary PVD. Uncomplicated UPEC-related rUTIs are more frequently associated with secondary PVD than are UTIs caused by different uropathogens.

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Special Considerations for Women with IBD

Cited by 22 publications

References 47 publications

Six Out of Ten Women with Recurrent Urinary Tract Infections Complain of Distressful Sexual Dysfunction – A Case-Control Study

Six Out of Ten Women with Recurrent Urinary Tract Infections Complain of Distressful Sexual Dysfunction – A Case-Control Study

Contraceptive method selection by women with inflammatory bowel diseases: a cross-sectional survey

Secondary Provoked Vestibulodynia in Sexually Active Women with Uncomplicated Recurrent Urinary Tract Infections

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