Assessment of Sexual Dysfunction Among Inflammatory Bowel Disease Patients

Introduction: It is well known that inflammatory bowel disease (IBD) adversely affects quality of life. However, its impact on the sexual functions of patients is not well defined. We hypothesized that IBD patients are at increased risk for sexual dysfunction. Methods: A single center prospective cross sectional study of IBD patients was performed. Disease activity was measured using the modified Mayo score and Harvey-Bradshaw index for ulcerative colitis and Crohn’s disease, respectively. Patients also completed self-reported questionnaires on basic demographics, female sexual function index (FSFI), international index of erectile function (IIEF) for males, patient health questionnaire (PHQ-9), and fatigue severity scale (FSS). Results: A total of 47 patients completed the survey. The mean age was 31.3±9 years and 21 (44.7%) of the respondents were males. There were 29 (61.7%) patients with Crohn’s disease and 18 (38.2%) with ulcerative colitis. Erectile function, orgasmic function, and sexual desire was impaired in 52.4%, 23%, and 81% male patients respectively. Only 23.8% male patients reported intercourse satisfaction and 26.3% male patients reported overall satisfaction. In male patients, there was a higher prevalence of sexual dysfunction for patients with active vs. inactive disease (60% vs. 33.3%) but these were not significant (p=0.25). For females, sexual dysfunction was present in 61.5% of patients with desire impaired in 96.7% and arousal impaired in 57.7%. Lubrication, orgasm, satisfaction, and pain were impaired in 50%, 53%, 50%, and 54% patients respectively. The proportion of sexual dysfunction was higher in active patients than in non-active patients (73.3% vs. 45.5%), but this was not statistically significant (p=0.15). Only 8% of the patients had been inquired about their sexual function in the past. We also found a high prevalence of depression (61.7%) and fatigue (45%) among IBD patients and depression was associated with sexual dysfunction. Patients with depression were had more sexual dysfunction compared to patients who were not depressed (36.8% vs. 71.4%; p=0.01). Conclusion: We discovered a higher prevalence of sexual dysfunction among IBD patients involving both genders. The sexual dysfunction was worsened in patients with active disease and depression. Physicians need to incorporate sexual function assessment in their clinical practice to address this important yet overlooked aspect of patient health that can adversely affect their quality of life.