Background: Sexual satisfaction is among the concerns of patients with Inflammatory Bowel Disease (IBD) being rarely addressed in the outpatient clinic and Quality of Life (QoL) questionnaires. At a time where patient-reported outcomes (PRO) grow in importance, the impact of the disease on sexual health must be valued. Objective: To assess the impact of IBD on the sexual satisfaction of patients.
Methods: A cross-sectional, self-administered, multimodal questionnaire was distributed to 18–65 year-old patients at the IBD outpatient clinic. It included the following validated instruments: The Short IBD Questionnaire (SIBDQ), Social Desirability Scale (SDS-SF), Sexual QoL Questionnaire-Male/Female (SQoL-M/F), Nine-item Patient Health Questionnaire (PHQ-9). Comparison with healthy controls. Statistics: ρ (rho) Test, t (t-student) Test and Kruskal-Wallis-Test.
Results: The study included 92 patients (38 Crohn's disease, 54 ulcerative colitis) and 100 healthy controls (49% vs. 43% <40 years old, 58.7% vs. 28% women), most with high-school education (56.5% vs. 60%) and stable relationships (mean 13.3 vs. 13.3 years).
A cut-off = 54 in the SIBDQ was identified to differentiate the self-perception of higher activity/less control of IBD. There was no difference in the social desirability scale in active, inactive and control patients (mean SDS-9 vs. 8.8 vs 9.8), so the reliability of the responses was homogeneous between groups.
The sexual satisfaction of the patients with controlled disease was similar to that of the control group (median 83.3% vs. 84.8%) but it was impacted in active disease (68.6%, p<0.1). Similarly, the incidence of depression was equivalent in inactive disease and in controls, being higher in active disease (PHQ-9 median 1 vs. 3 vs. 7, p<0.05). Indeed, patient-perceived disease activity was negatively correlated with sexual satisfaction, as measured by SQoL (ρ test, p=0.01) and strongly associated with a higher incidence of depression (score PHQ-9, ρ test p<0.001). Likewise, the degree of depression evolved alongside with sexual dissatisfaction (tTest, p=0.002).
Conclusions: The patient who considers his or hers disease controlled, has the same sexual satisfaction as a healthy individual. Sexual satisfaction is strongly influenced by the IBD activity perceived by the patient, but also by the increase in the degree of depression that the disease activity correlates to. Sexual health should therefore be addressed in the IBD outpatient clinic.