Study of sexual dysfunction in men with Rheumatoid Arthritis

Introduction: Sexuality is a very complex aspect of human being's life. Usually it is an ignored subject in various questionnaires for evaluation of Rheumatoid arthritis patients. Sexual function in such patients can be affected by pain, fatigue, functional limitations, stiff joints, depressive mood, negative body image, anxiety, mental distress, erectile dysfunction, hormonal disturbances and drug treatment. Aim: To study the importance of evaluating sexual dysfunction and the various causes for the same in Rheumatoid Arthritis in men. Materials and Method: 50 males between the ages of 30-55 years with Rheumatoid Arthritis in a tertiary health care centre in Karnataka were included in this study. Analysis: Patients were asked about various aspects of sexual functioning and main causes of dysfunction. Pain, libido, fatigue, depressive liability, erectile dysfunction and effect of drug treatment were included in the questionnaire. Results: 40 out of the 50 patients reported some kind of sexual disability / dysfunction. 35 out of 40 patients complained of pain/stiffness of joints/functional limitations/ fatigue as the cause of their disabilities. 6 out of 40 patients reported erectile dysfunction. 11 out of 25 patients reported reduced libido out of which 2 blamed chronic medication for their reduced libido. 2 out 40 patients admitted to altered body image to be the cause of sexual dysfunction. Mental distress and depressed mood were reported by 5 out of 40 patients. Conclusion: At the end of this study, we have come to the conclusion that the major cause of sexual disability / dysfunction in men having Rheumatoid Arthritis is pain/stiffness of joints/functional limitations/ fatigue. Second major cause is erectile dysfunction and decreased libido. Depression, drug therapy and altered body image are the other causes. All these things can be attended to using various modes of treatment if the patient is asked about sexual aspect of his life which can eventually lead to improvement in overall quality of life of the patient.