The impact of systemic lupus erythematosus on women's sexual functioning.

Abstract

We investigated the impact of systemic lupus erythematosus (SLE) and the mediating effects of psychosocial factors on women's sexual adjustment. Data were obtained through structured interviews and psychometric scales administered to 100 female subjects with SLE and 71 disease-free controls. Compared with controls, patients with SLE had a significantly higher rate of abstention (26 vs 4%, p < 0.01), a lower frequency of sexual activity among the sexually active (p < 0.05), diminished vaginal lubrication (p < 0.01), and poorer general sexual adjustment (p < 0.01). Greater disease severity was associated with more impairment in sexual function (p < 0.01). Variables mediating the relationship between diagnostic status and sexual outcome included age (delta R2 = 0.04, p < 0.01), relationship status (delta R2 = 0.03, p < 0.05), weight concerns (delta R2 = 0.05, p < 0.01), premorbid sexual adjustment (delta R2 = 0.04, p < 0.01), and depression (delta R2 = 0.03, p < 0.05). Seventy-two percent of patients with SLE were receptive to physician inquiry about sexual functioning and 82% desired further education about the sexual impact of the disease. Our results suggest that sexual impairment is not inevitable among women with SLE. The role that providers can play in helping to prevent sexual difficulties is discussed.