2316: Sexual Dysfunction in Women with Axial Spondyloarthritis: A Meta-Analysis of FSFI Total and Domain Scores

Background/Purpose: Beyond musculoskeletal manifestations, there is growing recognition of the systemic and psychosocial burden of axial spondyloarthritis (axSpA). Sexual health is an often-overlooked aspect of quality of life in affected women. However, the impact of axSpA on sexual dysfunction (SD) in women remains unknown.

Methods: We systematically searched PubMed, Embase, and Cochrane library for observational studies comparing women with axSpA fulfilling the Assessment of SpondyloArthritis international Society (ASAS) classification criteria versus age-matched healthy controls. Our outcomes of interest were total FSFI and individual domain scores (desire, arousal, lubrication, orgasm, satisfaction, and pain). Mean differences (MD) and 95% confidence intervals (CI) were calculated using a random-effects model in R version 4.5.0.

Results: We included four cross-sectional studies comparing women with axSpA to age-matched healthy controls. A total of 174 women with axSpA were included (114 with radiographic axSpA and 60 with non-radiographic axSpA). The mean age was 38.3 years. The FSFI total score was significantly lower in women with axSpA compared to healthy controls (MD -4.69 points; 95% CI -8.83 to -0.54). Significant impairments were also observed in the following FSFI domains: desire (MD -0.81; 95% CI -1.53 to -0.09), arousal (MD -1.07; 95% CI -1.64 to -0.50), lubrication (MD -0.87; 95% CI -1.57 to -0.16) and pain scores (MD -0.59; 95% CI -1.13 to -0.05). However, there were no significant differences in terms of orgasm (MD -0.79; 95% CI -1.83 to 0.26) or satisfaction (MD -0.63; 95% CI -1.75 to 0.49).

Conclusion: In this meta-analysis, women with axSpA had signs of sexual dysfunction and worse sexual health as compared with age-matched healthy controls, highlighting the importance of incorporating sexual health evaluation into routine axSpA care, regardless of radiographic status.