Sexual Dysfunction and Fibromyalgia Syndrome

Two articles have been e-published this month discussing sexual dysfunction in Fibromyalgia Syndrome.^{1 2}

The first article, e-published ahead of print in the journal Clinical Rheumatology, aimed to review the association between Fibromyalgia Syndrome and sexual dysfunction in women and possible mechanisms of such association.

For the study, the medical literature databases PubMed, MEDLINE, and EMBASE databases (1950-2008) were searched for the key words "fibromyalgia", "chronic pain", "sexual dysfunction", "female", "sexuality", "depression", and "quality of life". All relevant articles in English and secondary references were reviewed.

All of the reviewed studies showed that Fibromyalgia Syndrome is associated with sexual dysfunction in women.¹

The major findings were as follows: decreased sexual desire and arousal, decreased experience of orgasm, and increased pain with intercourse.¹

The researchers concluded that:

"[Fibromyalgia Syndrome], sexual dysfunction, and depression may be interrelated with the depressive mood responsible for desire and arousal problems. On the other hand, in [Fibromyalgia Syndrome] patients, the threshold at which sensory input becomes painful is lower than normal that can explain pain on intercourse. Additional studies are needed to evaluate the casual relationship and mechanism of association between FM and sexual dysfunction in women"¹

The second article, e-published ahead of print in the journal Rheumatology International, was an overview of the impact that rheumatic diseases have on sexual function.

According to the article, the reasons that rheumatic diseases may disturb sexual function are multifactorial and comprise disease-related factors as well as therapy. ²

The researchers concluded that:

"In rheumatoid arthritis and ankylosing spondylitis patients, pain and depression could be the principal factors contributing to sexual dysfunction. On the other hand, in women with Sjögren's syndrome, systemic lupus erythematosus and systemic sclerosis sexual dysfunction is apparently most associated to vaginal discomfort or pain during intercourse. Finally, sexual dysfunction in patients with Fibromyalgia Syndrome could be principally associated with depression, but the characteristic symptoms of Fibromyalgia Syndrome (generalized pain, stiffness, fatigue and poor sleep) may contribute to the occurrence of sexual dysfunction."²

The article went on to say that the treatment of sexual dysfunction will depend on the specific patient's symptoms. However, there are some general recommendations made in the article, including: exploring different positions, using analgesics drug, heat and muscle relaxants before sexual activity and exploring alternative methods of sexual expression.²

References:

1. Kalichman L. Association between fibromyalgia and sexual dysfunction in women. Clin Rheumatol. 2009 Jan 23. [Epub ahead of print]
2. Tristano AG. The impact of rheumatic diseases on sexual function. Rheumatol Int. 2009 Jan 20. [Epub ahead of print]