Rheumatology-led pregnancy clinic: men perspective

Abstract

The birth of reproductive rheumatology as a subject of interest in rheumatology has led to improvement of clinical care for patients living with autoimmune rheumatic diseases and paved the way towards setting a specialized pregnancy service within the standard rheumatology practice. In contrast to women, where there has been wealth of literature regarding pregnancy, lactation, and birth outcomes, there is not as much focusing on male sexual health and outcomes among inflammatory arthritis patients. Challenges such as decrease ability to conceive, impaired fertility, erectile dysfunction, and other sexual problems have been raised by male patients living with autoimmune rheumatic diseases. This broad scope gives the reproductive health concept in men another expansion with views to include sexual health problems screening among men attending the standard outpatient rheumatology clinics. This article adds to the paucity of real-life experience and aims at discussing the sexual health from the men perspective and provides a practical approach towards screening, and assessment of men living with autoimmune diseases in standard day to day practice.

Keywords: Autoimmune rheumatic diseases; Biologic therapy; DMARDs; Fertility; Men; Pregnancy.

Fig. 1

The main steps in handling men’s sexual health in rheumatology-led pregnancy clinic

Fig. 2

Flowchart describing a proposed set-up of the pregnancy clinic and how to evaluate men living with autoimmune rheumatic diseases and presenting with sexual problems/concerns or planning for a family