title: The impact of primary Sjögren's syndrome on female sexual function.
abstract: OBJECTIVE
  Prevalence of vaginal dryness and dyspareunia is high in women with primary SS (pSS). Our aim was to compare sexual function and sexual distress in women with pSS with healthy controls, as well as to assess parameters that are associated with sexual dysfunction and distress in pSS.
  
  
  METHODS
  Forty-six women fulfilling the American-European Consensus Group criteria for pSS [mean age 46.3 years (s.d. 10.5)] and 43 age-matched healthy controls were included. Participants completed self-administered questionnaires, namely the Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS), Multidimensional Fatigue Inventory (MFI), Hospital Anxiety and Depression Scale (HADS), Maudsley Marital Questionnaire (MMQ) and RAND 36-item Health Survey (RAND-36). In addition, the European League Against Rheumatism Sjögren's Syndrome Disease Activity Index (ESSDAI) and Patient Reported Index (ESSPRI) were recorded in patients.
  
  
  RESULTS
  Women with pSS had impaired sexual function compared with healthy controls (median FSFI 20.6 vs 30.3, P < 0.001), as reflected by significantly lower scores in the domains of desire, arousal, orgasm, lubrication and pain. Furthermore, pSS patients experienced more sexual distress (median FSDS 7 vs 4, P < 0.05) and were sexually active less frequently than controls (76% vs 93%, P < 0.05). Sexual dysfunction correlated significantly with patient-reported symptoms of pSS (ESSPRI), symptoms of fatigue (MFI), depressive symptoms (HADS), relationship dissatisfaction (MMQ) and lower mental quality of life (RAND-36), but not with systemic disease activity (ESSDAI).
  
  
  CONCLUSIONS
  Women with pSS have impaired sexual function and more sexual distress compared with healthy controls. Sexual function and distress are influenced by vaginal dryness and patient-reported symptoms of pSS as well as psychosocial factors.
authors: Department of Rheumatology and Clinical Immunology and Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands j.f.van.nimwegen@umcg.nl.
authors: Jolien F
authors: JF
authors: van Nimwegen
authors: Department of Rheumatology and Clinical Immunology and Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors: Suzanne
authors: S
authors: Arends
authors: Department of Rheumatology and Clinical Immunology and Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors: Greetje S
authors: GS
authors: van Zuiden
authors: Department of Rheumatology and Clinical Immunology and Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors: Arjan
authors: A
authors: Vissink
authors: Department of Rheumatology and Clinical Immunology and Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors: Frans G M
authors: FG
authors: Kroese
authors: Department of Rheumatology and Clinical Immunology and Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors: Hendrika
authors: H
authors: Bootsma
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D004414:Dyspareunia / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D005221:Fatigue / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D012725:Sexual Behavior / Q000502:physiology* / Q000523:psychology*; D012859:Sjogren's Syndrome / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D014621:Vagina / Q000503:physiopathology
keywords: Female Sexual Distress Scale; Female Sexual Function Index; Sjögren’s syndrome; aetiology; healthy volunteers; sexual distress; sexual dysfunction; vaginal dryness