Taboos Around The Impact of Rheumatoid Arthritis on Patients' Sex Lives

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Sex and Rheumatoid Arthritis

New research, presented today at the 7th EULAR annual congress, reveals one third of rheumatoid arthritis patients feel their condition has 'considerably' negative influence on their sexual activity.

Around a third of patients (31%) reported no impact on sexual activity, with an additional 38% reporting only 'little' impact. In contrast, 21% reported their condition as having a considerable impact on their sexuality, with one in 10 reporting their rheumatoid arthritis made sexual activity either almost or totally impossible.

Compared to the female patients, men were more likely to report large impact of health status on sexual activity (27.8%, 40.0%, p= 0.001) , with patients with less than 12 years of education more likely to report large impact, compared to those with more than 12 years education (35.4%, 24.6%, p= 0,001).

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Surprisingly, whilst joint pain associated with the disease was not reported as playing a significant factor, higher levels of fatigue (tiredness) and functional limitation predicted perceived problems with sexual activity.

The study aimed to examine the prevalence of self-reported problems with sexual activity in patients with Rheumatoid Arthritis, and associations to demographic and disease related variables. 1041 patients (mean (SD) age 61.7 (15.0) years, mean (SD) disease duration 14.08 (10.9) years, female 78%) responded to a postal questionnaire in 2004 comprising several health status measures. Out of the 1041 respondents, 830 patients answered question 15 in the Health Utility Questionnaire 15D, which addressed the perceived level of problems with sexual activity. Pain and fatigue visual analogue scale (VAS, 100 mm), Arthritis Impact Measurement Scale (AIMS2) and Health Assessment Questionnaire (HAQ, range 0-3) were included as disease related variables. The 5 response groups were dichotomised into "no/little impact" on sexual activity or "large impact" (considerable impact/almost impossible/impossible to have sexual activity).

"Today's findings indicate the need for increased attention on effect of rheumatoid arthritis on sexual activity as well as reveal that sexual problems should be addressed as part of the general health care given to RA patients," explained Ylva Helland, department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. "The complexity of the issue requires a broad and multi-disciplinary approach by health personnel to ensure patients are not limited in their ability to have sex".

Rheumatoid arthritis has a wide ranging impact on patients' health, causing multiple medical, physical and psychological problems, all of which have the potential to impair patients' ability to conduct everyday tasks that others take for granted. In this light, whilst it would seem logical that considerable prevalence of sexual problems exist amongst rheumatoid arthritis patients, research in the area of sexuality has been limited.

The subject of sexuality and RA also features within a separate EULAR speaker session, which amongst other things focuses on the approaches that healthcare professionals can take when discussing sexuality with

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