Background: Sexual dysfunction is a well-recognized complication of chronic illness. In IBD factors such as age of diagnosis, increased bowel frequency, abdominal pain, fatigue, incontinence, perianal fistulas, abscesses, or skin tags, can lead to an accumulation of physical and psychosocial factors that can impair sexual function. Although 80% of IBD patients report sexual dysfunction only 40% will discuss it with their healthcare provider. Dyspareunia has been reported as occurring in unto 40% of patients with IBD.
Methods: We analyzed Rome III IBS symptoms, disease activity indices, and psychological, somatization, and quality of life data from 777 consecutive, unselected adult patients with IBD seen in clinics at St James's University Hospital in Leeds, United Kingdom from November 2012 through June 2015. Participants also provided a stool sample for fecal calprotectin (FC) analysis and serum for CRP.
Results: The overall prevalence of dyspareunia in our IBD cohort was 11.2%. 5.5% of males reported dyspareunia (19/348) compared to 18.2% of females (78/429) (p<0.0001). 64.4% (55/87) of patients reporting dyspareunia were married compared to 60.4% (417/690) of patients without dyspareunia. The median age of patients with dyspareunia was 37 years compared to 42 years without. Median BMI was 25.58 in the group with dyspareunia and 24.53 in the group without. 11.5% of patients with Crohn's disease (51/444) reported dyspareunia compared to 10.8% of UC patients (36/333) (p=0.8186). Prevalence of prior surgery was 25.3% (22/87) in the dyspareunia group compared to 25.8% of those without (178/690). Prevalence of perianal disease was 3.5% (3/87) in the dyspareunia group compared to 4.2% of those without (29/690). Median FC was 174.6 in the dyspareunia group compared to 150.1 of those without. CRP was elevated in 35.6% (31/87) of patients with dyspareunia group compared to 39.4% of those without (272/690). 54.0% (47/87) of patients with dyspareunia reported the presence of IBS-type symptoms compared to 34.8% (240/690) of those without (p=0.0006). Median Somatic Symptom Scale - 8 (SSS-8) was 15 in the dyspareunia group compared to 9 in those without. Patient Health Questionnaire-12 (phq12) somatisation score was 11 in the dyspareunia group compared to 6 in those without.
Conclusions: The prevalence of dyspareunia in our centre is lower than some of the previously reported iBD cohorts. Dyspareunia was associated with IBS-type symptoms, female gender and higher somatisation scores but not with disease phenotype or other demographic factors.