New scale measures sexual dysfunction in women with IBD

Last Updated: 2018-07-02

By Anne Harding

NEW YORK (Reuters Health) - Clinicians now have a validated 15-item scale for assessing sexual dysfunction in women with inflammatory bowel disease (IBD), who face unique sexual health challenges in terms of their illness and treatment.

"Women with ulcerative colitis and Crohn's disease have a chronic disease which often involves the use of biologics and potentially surgeries which could significantly affect their sexual function," Dr. Punyanganie de Silva of Brigham and Women's Hospital in Boston, the lead author of the new study, told Reuters Health in a telephone interview.

Up to 60% of women with IBD report sexual dysfunction, Dr. de Silva and her colleagues note in their June 22 report in Inflammatory Bowel Disease, "although current data are scarce and based on small survey studies and case series."

They developed the Inflammatory Bowel Disease-Female Sexual Dysfunction Scale (IBD-FSDS) using survey data from 454 women with IBD, including 267 from the U.S. and 187 from Denmark.

The survey showed that about 40% of women were afraid of experiencing pain with sex, while about one-fourth of U.S. women and one-third of Danish women said they felt unattractive due to their IBD. Seventy-three percent of the U.S. women and 63% of the Danish women said they would be "comfortable" talking about sex with their doctor, while 15.2% and 5.4%, respectively, said their doctor had raised the subject with them.

Roughly two-thirds of the women said IBD had led to distress in their relationships, and about 28% said IBD activity had prevented them from having sex. Many women also reported feeling guilty or fearful about sex. Among U.S. women, IBD-FSDS score was associated with depression and worse disease activity, and no history of surgery. For Danish women, only depression was significantly associated with IBD-FSDS score.

The validated IBD-FSDS includes 15 questions focused on concerns specific to UC and Crohn's patients.

Pelvic pain, diarrhea and bleeding due to IBD can affect a woman's libido as well has her comfort with having sex, Dr. de Silva noted. "There's also the psychological component, where women with inflammatory bowel disease feel very fatigued, particularly if their disease is not well controlled and that itself could affect their sexual function," she added.

Response from physicians and patients who participated in pilot testing of the IBD_FSDS was "overwhelmingly positive," according to Dr. de Silva. She urged doctors to be more aware of sexual dysfunction in their IBD patients, and more open to discussing it with them.

"Obviously having a tool like this helps to initiate that conversation in an easier manner for the physician and sometimes the patient as well," she said.

The topic of sexual function in IBD patients has been "taboo," Dr. Konstantinos H. Katsanos of the University of Ioannina School of Medical Sciences in Greece and colleagues note in a commentary accompanying the findings.

"This is the first good attempt to try to approach and investigate this problem, because it's really a problem," Dr. Katsanos told Reuters Health in a telephone interview.

Clinicians may need to refer IBD patients with sexual dysfunction to a gynecologist or a psychiatrist, he said, adding, "These problems need a multidisciplinary team."

There is also a need for a validated questionnaire for measuring sexual dysfunction in male IBD patients, who can experience sexual health challenges due to illness and treatment, Dr. Katsanos said.

SOURCE: http://bit.ly/2lQ3Ay8 and http://bit.ly/2lOyZkB

Inflamm Bowel Dis 2018.