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Sex in IBD: Does Disease Activity Drive Dysfunction?
Among patients with inflammatory bowel disease (IBD), sexual dysfunction (SD) and erectile dysfunction (ED) do not appear to be associated with objective measures of disease activity, according to a new study published in Inflammatory Bowel Disease.
Adult patients with IBD who were undergoing ileocolonoscopy were prospectively recruited to provide information on sexual function as measured by the Female Sexual Function Index and International Index of Erectile Function; disease activity as measured by endoscopy, biomarkers, and symptoms; psychological symptoms; and quality-of-life. Rates of SD and ED among patients with active and inactive inflammation and symptoms were compared using the Fisher’s exact test, while association between SD and ED, disease characteristics, and psychological symptoms were examined by logistic regression.
Of the 159 participants, 97 had Crohn’s disease and 85 were women, the researchers reported. “SD was reported in 36 of 59 and 13 of 59 sexually active women and men, respectively, and ED in 22 of 59 sexually active men. Rates of SD and ED were similar between individuals with active and inactive IBD based on endoscopic indices (P > .05) and biomarkers (P > .05),” the authors wrote. “Women with active IBD symptoms experienced significantly higher rates of SD (P < .05), but men did not (P > .05). Multivariable logistic regression identified that symptoms of severe depression (odds ratio, 5.77; 95% confidence interval, 1.59-20.94) were associated with SD in women, and severe anxiety (odds ratio, 15.62; 95% confidence interval, 1.74-140.23) was associated with ED in men.”
The researchers concluded that objective measures of disease activity are not associated with erectile or sexual dysfunction among patients with IBD. Therefore, they wrote, “Clinicians should consider concomitant psychological symptoms contributing to the sexual health of patients with IBD.”
For more on this important subject, be sure to listen to this podcast from IBD Drive Time, hosted by Dr David Rubin: “Let’s Talk About Sex and IBD.”
Reference:
Mules TC, Swaminathan A, Hirschfeld E, et al. The impact of disease activity on sexual and erectile dysfunction in patients with inflammatory bowel disease. Inflammatory Bowel Diseases. 2023;29(8: 1244–1254, https://doi.org/10.1093/ibd/izac204
