P824 Sexual Dysfunction among young patients with Crohn´s disease. A Spanish case control study.
Gutiérrez Casbas, A.(1);Madero Velázquez, L.(2)*;Herreros, B.(3);Zapater, P.(4,5);Rodríguez, A.(6);Muñoz, R.(6);Bernal, L.(6);Orts, B.(7);Belen, O.(6);Sempere, L.(2);Moreno-Pérez, O.(8);Francés, R.(9,10);
(1)Hospital General Universitario Alicante, Gastroenterology- CIBERehd- Instituto de Investigación Sanitaria y Biomédica de Alicante ISABIAL, Alicante, Spain;(2)Hospital General Universitario Dr Balmis de Alicante- ISABIAL, Gastroenterology, Alicante, Spain;(3)Hospital Marina Baixa- Villajoyosa, Gastroenterology, Alicante, Spain;(4)Hospital General Universitario Dr Balmis de Alicante- ISABIAL- Universidad Miguel Hernández Elche, Clinical Pharmacology, Alicante, Spain;(5)CIBERehd, CIBERehd, Madrid, Spain;(6)Hospital General Universitario Dr Balmis de Alicante, Gastroenterology, Alicante, Spain;(7)Hospital General Universitario Dr Balmis de Alicante- ISABIAL, Clinical Pharmacology, Alicante, Spain;(8)Hospital General Universitario Dr Balmis de Alicante- ISABIAL- Universidad Miguel Hernández- Elche, Endocrinology, Alicante, Spain;(9)Universidad Miguel Hernández Elche, Immunology- Department of Clinical Medicine, Alicante, Spain;(10)CIBERehd, Immunology, Madrid, Spain;
Background
Sexuality is a complex entity and a major determinant of quality of life in patients diagnosed with inflammatory bowel disease (IBD). It has been estimated that sexual dysfunction (SD) affects 30% of women and 5% of men in the general population as well as 50% in women and 25% in men with IBD.Objectives:To compare the rates of SD between young female and male patients with Crohn's disease (CD) and healthy controls matched by age and sex and to search for predictors of SD in CD patients.
Methods
Observational, case-control, prospective study including CD patients with CD, 18-40 years of age. Age and sex-matched (2:1) healthy controls (HC) were selected.
Demographic characteristics of all subjects and clinical features of CD were collected. The variables explored were SD in women (Index of Female Sexual Function (IFSF), SD in men (International Index of Erectile Function [IIFE-15]) and presence of anxiety-depression (Hospital Anxiety/Depression Scale [HADS]).
Results
A total of 163 subjects were included: 83 men (58 CD, median 28 years (RIQ 24-36) and 25 male HC, median 31 years (RIQ 26-37) and 80 women (50 female CD, median 26 years (RIQ 21-36) and 30 HC, median 28 (RIQ 26-32). 24% of women with CD and 8% of men had clinical activity (HBI >4). Table 1 summarizes main clinical characteristics of overall study population. Demographic characteristics of men with CD and HC were not significantly different. Sedentary lifestyle was more common among women with CD vs HC (46% vs 3.3%, p<0.001), as well as educational level (universitary studies 44% CD vs 83%, HC,p= 0.003) and employment status (unemployment CD 26% vs CS 3%, p=0.01) were significantly different between groups.
SD in men, measured by IIFE, was more common in CD patients than among HC, 14/58 (24%) vs 1/25 (4%), p=0.031. CD male patients scored significantly lower than HC regarding overall sexual satisfaction 8 (6-9) vs 9 (8-10), p=0,02. Erectile dysfunction occurred only in CD (7/46, 15%), p= 0.08. Female SD was, likewise more frequent in women with CD vs female HC, (18/50 (38%) CD vs 3/30 (12%) HC,p=0.017), and female CD patients scored significantly lower with regard sexual desire (5 vs 7, p=0.008), arousal (9.0 vs 11, p=0.06) and lubrication (10 vs 13, p=0.04) than female HC. Logistic regression analysis showed that only anxiety was associated with SD in women, finding no associated risk factors with SD in CD male patients.
Conclusion
CD patients present a disease activity-independent higher risk of SD compared to the general population. Domain affected in male patients is impairment of satisfaction whereas lubrication, sexual desire and arousal, being associated with anxiety, are affected in female CD patients.