Barbora Heřmánkováa b c, Maja Špiritovića b c, Sabína Oreskác d e, Hana Štorkánovác d e, Hana Šmucrovád, Martin Komarcf, Martin Kleinc d e, Karel Pavelkác d e, Ladislav Šenoltc d e,
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Idiopathic inflammatory myopathies (IIM) are rare diseases characterized by chronic muscle inflammation and multiple organ involvement. These serious clinical manifestations can be associated with significant impairment of quality of life, including sexual life.This study aimed to compare sexual function in patients with IIM to age-/sex-matched healthy controls (HC) and determine the potential impact of clinical features on sexual function.In total, 62 women with IIM [mean age: 53.1, disease duration: 5.2 years, dermatomyositis (DM, 29)/ polymyositis (PM, 27)/ necrotizing myopathy (IMNM, 5)/ inclusion body myositis (IBM, 1)], who fulfilled the Bohan/Peter 1975 criteria for DM/PM, or ENMC criteria for IMNM or IBM, and 62 healthy controls (HC) (mean age: 53.1) without rheumatic diseases filled in 11 well-established and validated questionnaires assessing sexual function (FSFI, SFQ28, BISF-W, SQoL-F), pelvic floor function (PFIQ-7, PISQ-12), fatigue (FIS, Fatigue Impact Scale), physical activity (HAP, Human Activity Profile), disability (HAQ, Health Assessment Questionnaire), depression (BDI-II, Beck’s Depression Inventory-II), and quality of life (SF-36, Medical outcomes study Short Form 36 – PCS, Physical Component Summary; MCS, Mental Component Summary). A routine laboratory testing was performed. Data are presented as median (IQR).Patients with IIM reported significantly greater prevalence and severity of sexual dysfunction (FSFI, BISF-W, SFQ28, SQoL-F) and pelvic floor dysfunction (PISQ-12, PFIQ-7) compared to HC (Table 1). The prevalence of sexual dysfunction in patients with IIM according to the FSFI cut-off score was 59%. Worse scores in IIM patients were associated with greater muscle weakness of m. gluteus maximus [MMT: FSFI (r=0.289, p=0.035), PFIQ-7 (r=-0.407, p=0.003)], m. gluteus medius [MMT: PFIQ-7 (r=-0.381, p=0.005)], more pronounced fatigue [FIF: SQoL-F (r=-0.412, p=0.003)], severer depression [BDI-II: SQoL-F (r=-0.459, p=0.0007)], worse functional disability [HAQ: FSFI (r=-0.436, p=0.005)], reduced physical activity [HAP: FSFI (r=0.403, p=0.001), SQoL-F (r=0.368, p=0.007)], and decreased quality of life [SF-36 PCS: FSFI-total (r=0.381,p=0.002), SF-36 MCS: SQoL-F (r=0.407, p=0.002)]. We did not observe any associations with disease duration, the current prednisone dose, or serum levels of muscle enzymes.Women with IIM reported significantly impaired sexual function and pelvic floor function compared to age-/sex-matched healthy controls. Worse scores in IIM were associated with disease-related features.Table 1.Sexual function and pelvic floor function in women with IIM and healthy controlsQuestionnaire: score range (meaning)IIM (n=62)HC (n=62)p-valueFSFI: Female Sexual Function Index: 2 (worst) - 36 (best)18.2 (3.2-28.5)28.4 (14.4-32.1)p=0.006BISF-W: Brief Index of Sexual Function forWomen: -16 (worst) - 75 (best)18.6 (2.7-32.3)34.0 (8.0-44.7)p=0.004SQoL-F: Sexual Quality of Life Questionnaire – Female: 0 (worst) - 100 (best)60.0 (41.4-83.6)86.7 (70.8-95.6)p<0.0001PISQ–12: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form: 0 (best) - 48 (worst)14.5 (9.0-18.0)8.0 (5.0-12.0)p<0.0001PFIQ7: Pelvic Floor Impact Questionnaire – short form 7: 0 (best) - 300 (worst)4.8 (0.0-23.8)0.0 (0.0-4.8)p=0.052SFQ-28: Sexual Functioning Questionnaire-28 desire: 5 (worst) - 31 (best)18.0 (13.3-20.0)19.0 (17.0-22.0)p=0.042SFQ-28 arousal sensation: 4 (worst) - 20 (best)9.5 (7.0-11.0)12.0 (9.0-14.3)p=0.082SFQ-28 arousal lubrication: 2 (worst) - 10 (best)6.0 (4.0-8.0)7.0 (5.0-9.0)p=0.112SFQ-28 arousal cognitive: 2 (worst) - 10 (best)6.0 (4.3-7.0)6.0 (5.0-7.3)p=0.235SFQ-28 orgasm: 1 (worst) - 15 (best)11.0 (8.0-13.0)12.0 (9.8-13.0)p=0.279SFQ-28 pain: 2 (worst) - 15 (best)12.0 (10.0-15.0)15.0 (13.0-15.0)p=0.004SFQ-28 enjoyment: 6 (worst) - 30 (best)19.0 (14.3-24.3)23.0 (19.0-25.0)p=0.027SFQ-28 partner: 2 (worst) - 10 (best)9.0 (8.0-10.0)10.0 (9.0-10.0)p=0.012Supported by MHCR 023728, GA UK 1578119, and SVV 260373None declared
TL;DRWomen with IIM reported significantly impaired sexual function and pelvic floor function compared to age-/sex-matched healthy controls and worse scores in IIM patients were associated with disease-related features. (Semantic Scholar)
