Sexual Dysfunction and Inflammatory Bowel Disease

Punyanganie S. de Silva | TOUKOKUU 2019 | |

Punyanganie S. de Silva
MD,
Crohn’s and Colitis Center,
Brigham and Women’s Hospital
& Harvard Medical School,
Boston, Massachusetts, USA

Sonia Friedman
Associate Professor, MD,
Crohn’s and Colitis Center,
Brigham and Women’s Hospital
& Harvard Medical School,
Boston, Massachusetts, USA

Sexual dysfunction is more common among men and women with Inflammatory Bowel Disease (IBD) than in the background population. Previous studies have shown that about 40-60% of women with IBD and up to 44% of men with IBD report sexual dysfunction.1,2 A recent meta-analysis by Zhao et al. of eight studies with control groups found that IBD was significantly associated with an elevated risk of sexual dysfunction in men (relative risk [RR]: 1.41; 95% CI: 1.09–1.8) and women (RR: 1.76; 95% CI: 1.28–2.42).3  Inflammatory bowel disease patients with a relatively young age (male: <50 years; female: <40 years) had significantly increased odds of sexual dysfunction compared with controls. Six of the studies in this meta-analysis used the “gold standard” Female Sexual Function Index (FSFI)4 and International Index of Erectile Function (IIEF)5 for comparison of sexual function in patients with IBD to that of individuals in the general population. The other two studies in the meta-analysis were cohort studies.  The first was a Danish national registry study of 31,498 men with IBD and 314,980 age-matched men without IBD, where the main outcome was a first prescription of an ED medication.6 The authors adjusted for central nervous system and intestinal anti-inflammatory medications, systemic corticos-teroids and co-morbidities. Overall, men with Crohn’s dis-ease (CD) or ulcerative colitis (UC) are more likely to fill an ED prescription than men without IBD. This result was significant regardless of a history of IBD surgery.  The adjusted hazard ratio (HR) for UC was 1.17 (95% CI: 1.10–1.24) (no operation) and 1.43 (95% CI: 1.27–1.61) (prior operation), and for CD 1.26 (95% CI: 1.15–1.38) (no operation) and 1.20 (95% CI: 1.06–1.35) (prior operation). Kao et al. examined erectile dysfunction in a Taiwanese population of men with IBD and found that patients with IBD had a 1.64-fold higher risk of...