DO COPING STRATEGIES, ILLNESS PERCEPTIONS AND RELATIONSHIP DYNAMICS CONTRIBUTE TO SEXUAL DYSFUNCTION FOR WOMEN WITH SJOGREN'S SYNDROME?

BackgroundWomen with Sjögren’s syndrome (SS) are more likely to experience vaginal dryness, dyspareunia and reduced sexual function than healthy controls1. There is limited data investigating relationships with psychosocial influences, such as coping mechanisms, illness perceptions, partners behaviours and relationship satisfaction.ObjectivesTo investigate associations between sexual function and psychosocial parameters in women with SS.MethodsCisgender women aged 18+, diagnosed with SS, were invited to participate in a cross-sectional online survey. Ethical approval and informed consent were obtained. Participants completed the Female Sexual Function Index (FSFI), EULAR Sjӧgren’s Syndrome Patient Reported Index (ESSPRI), NRS scale for vaginal dryness (0-10), Profile of Fatigue and Discomfort (ProFaD), Cognitive Emotion Regulation Questionnaire (CERQ), Brief Illness Perceptions Questionnaire (BIPQ), West-Haven Yale Multidimensional Pain Inventory (WHYMPI – Part II) and Maudsley Marital Questionnaire (MMQ – Marital subscale). Associations between the FSFI and the outcome measures were assessed using Spearman’s correlations. Variables that significantly correlated with FSFI total score were entered into a backward stepwise multiple regression.ResultsThe survey was completed by 98 women (M = 48.13, SD = 13.26), 70.4% were diagnosed as having primary SS (disease duration range = 3 – 348 months); 43.8% were premenopausal and 48% were postmenopausal. Vaginal dryness was reported by 92.9% of participants, and sexual dysfunction was identified in 85.2% (n = 69/81) of cases (<26.55). Participants who were not sexually active in the previous three-month period (n = 17) were excluded from analyses as inactivity may cause a low FSFI score which may be incorrectly construed as sexual dysfunction. Reduced sexual function was significantly associated with increases in age, vaginal dryness, mental fatigue (ProFaD), self-blame, rumination and catastrophising (CERQ), consequences and identity (BIPQ), negative partner responses (WHYMPI) and relationship dissatisfaction (MMQ). Reduced sexual function was also significantly associated with decreases in positive reappraisal and perspective (CERQ), personal control (BIPQ), solicitous responses and distracting responses (WHYMPI) (Table 1). No significant associations were found for disease duration, relationship duration or ESSPRI total. Results from regression analyses indicated that vaginal dryness (β = -.278, p = .004), CERQ positive reappraisal (β = .322, p = .003) and CERQ catastrophising (β = -.277, p = .009) were significantly related to sexual function and explained 42.0% of the variance in total FSFI scores (F(3,72) = 17.394, p < .001).Table 1.Associations between sexual function and psychosocial parametersFSFI totalrsp95% CI (LB, UB)Age (years)-.270.015-.467-.049Disease duration (months)-.030.793-.253.196Relationship duration (months)-.180.119-.396.054VAS Vaginal dryness-.350.001-.533-.136ESSPRI total-.165.141-.376.062ProFaD Mental Fatigue-.294.008-.486-.074CERQ Self-Blame-.264.017-.461-.042CERQ Rumination-.296.007-.488-.077CERQ Positive Reappraisal.469.000.273.628CERQ Perspective.341.002.126.525CERQ Catastrophising-.499.000-.651-.310BIPQ Consequences-.237.033-.438-.013BIPQ Personal Control-.288.009-.481-.068BIPQ Identity-.294.008-.487-.075MMQ-.282.013-.483-.054WHYMPI Negative Responses-.252.028-.457-.021WHYMPI Solicitous Responses.267.020.037.470WHYMPI Distracting Responses.311.006.085.506Note. N = 81. Associations that were not significant are not shown.ConclusionWomen with SS using positive coping strategies have better sexual function than those with negative coping strategies. Learning positive coping strategies may be an important line of approach for managing sexual dysfunction in SS.References[1]Priori R, et al. Quality of sexual life in women with primary Sjögren syndrome. J Rheumatol. 2015;42(8): 1427-31.Disclosure of InterestsNone declared