title: Impaired sexual function in women with systemic sclerosis: a cross-sectional study.
abstract: OBJECTIVE
  To compare sexual functioning and distress in women with systemic sclerosis (SSc) with that in healthy controls and determine the association between disease characteristics and sexual function.
  
  
  METHODS
  We conducted a cross-sectional study of 69 women with SSc (ages 18-60 years) and 58 healthy, age-matched controls. Assessment included the Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS), Hospital Anxiety and Depression Scale, Short Form 36 health survey, sociodemographic characteristics, and in patients only, the Health Assessment Questionnaire.
  
  
  RESULTS
  Of 69 eligible patients with SSc, 37 (54%) responded, in addition to 37 (64%) of 58 controls. The FSFI total score and the subscale scores for lubrication, orgasm, arousal, and pain were significantly lower and the FSDS scores were significantly higher in patients with SSc. Longer disease duration and higher levels of marital dissatisfaction were significantly associated with low sexual function in patients with SSc. Longer disease duration, more depressive symptoms, and the use of antidepressants were significantly associated with sexual distress. Multivariate analyses indicated that marital distress was the only variable significantly associated with low sexual function in patients with SSc (beta = 0.40, P < 0.05), whereas depression was the only variable significantly associated with sexual distress (beta = 0.32, P < 0.05). The same pattern of associations was found in the healthy control group.
  
  
  CONCLUSIONS
  Women with SSc reported significantly impaired sexual functioning and more sexual distress then healthy controls. Impaired sexual functioning and sexual distress were associated with marital distress and depressive symptoms. These results indicate that in daily practice, inquiring about sexuality and screening for depressive symptoms is indicated in every patient with SSc, irrespective of their clinical characteristics.
authors.affiliation: Department of Rheumatology, C-01-Q, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. A.A.Schouffoer@LUMC.nl
authors.forename: A A
authors.initials: AA
authors.lastname: Schouffoer
authors.forename: J
authors.initials: J
authors.lastname: van der Marel
authors.forename: M M
authors.initials: MM
authors.lastname: Ter Kuile
authors.forename: P T M
authors.initials: PT
authors.lastname: Weijenborg
authors.forename: A
authors.initials: A
authors.lastname: Voskuyl
authors.forename: C W
authors.initials: CW
authors.lastname: Vliet Vlieland
authors.forename: J M
authors.initials: JM
authors.lastname: van Laar
authors.forename: T P M
authors.initials: TP
authors.lastname: Vliet Vlieland
mesh_terms: D000328:Adult; D000342:Affective Symptoms; D003376:Counseling; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D012595:Scleroderma, Systemic / Q000453:epidemiology* / Q000523:psychology*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology*; D019529:Sexuality / Q000523:psychology; D011795:Surveys and Questionnaires