Determinants of female sexual function in inflammatory bowel disease: a survey based cross-sectional analysis

Abstract

Background: Sexual function is impaired in women with inflammatory bowel disease (IBD) as compared to normal controls. We examined disease specific determinants of different aspects of low sexual function.

Methods: Women with IBD aged 18 to 65 presenting to the university departments of internal medicine and surgery were included. In addition, a random sample from the national patients organization was used (separate analyses). Sexual function was assessed by the Brief Index of Sexual Function in Women, comprising seven different domains of sexuality. Function was considered impaired if subscores were <-1 on a z-normalized scale. Results are presented as age adjusted odds ratios with 95% CI based on multiple logistic regression.

Results: 336 questionnaires were included (219 Crohn's disease, 117 ulcerative colitis). Most women reported low sexual activity (63%; 17% none at all, 20% moderate or high activity). Partnership satisfaction was high in spite of low sexual interest in this group. Depressed mood was the strongest predictor of low sexual function scores in all domains. Urban residency and higher socioecomic status had a protective effect. Disease activity was moderately associated with low desire (OR 1.8, 95% CI 1.0 to 3.2). Severity of the disease course impacted most on intercourse frequency (OR 2.3, 95% CI 1.4 to 4.7). Lubrication problems were more common in smokers (OR 2.5, 95% CI 1.3 to 5.1).

Conclusion: Mood disturbances and social environment impacted more on sexual function in women with IBD than disease specific factors. Smoking is associated with lubrication problems.

Figure 1

BISF-W scores (z-values) by case group, women with partners only. 0: standard population mean, +/- 1 = +/- 1 standard deviation from standard population mean. *specific problems: higher value = more problems, other scores: higher value = better function.

Figure 2

Results from EORTC-QLQ CR30 items, clinical sample only (n = 114). Proportions of those answering "very"/"moderate" (vs. "little"/"not at all").

Figure 3

Frequency with which different problems were felt to have impacted negatively on sexual activities (women with partners only).