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P616. Sexual dysfunction in men and women with inflammatory bowel disease

A. Vollebregt1, L. Bel1, A. van der Meulen1, H. Fidder2, R. Ten Hove3, C. Vliet-Vlieland4,5, M. ter Kuile4, E. de Groot4, S. Both4, 1Leiden University Medical Center, Gastroenterology, Leiden, The Netherlands, 2University Medical Centre Utrecht, Gastroenterology, Utrecht, The Netherlands, 3Diaconessen­huis Leiden, Gastroenterology, Leiden, The Netherlands, 4Leiden University Medical Center, Outpatient Clinic for Psychosomatic Gynaecology and Sexology, Leiden, Netherlands, 5General Practitioner Practice 't Wantveld, Noordwijk, The Netherlands

Background

Inflammatory bowel disease (IBD) is likely to have an impact on sexual function. Depression is commonly reported in IBD and is known to be related to sexual dysfunction. This study aimed to evaluate sexual function and its association with depression among women and men with IBD relative to controls.

Methods

IBD patients registered at an academic and peripheral hospital in the Netherlands were asked to participate and to fill out a web-based questionnaire. The control group consisted of a general practitioner practice population (N = 197), matched for age and sex. To evaluate sexual function the Female Sexual Function Index (FSFI) was used for women and the International Index of Erectile Function (IIEF) for man. Further variables evaluated were depression (Hospital Anxiety and Depression Scale), disease activity (Harvey Bradshaw Index and Simple Clinical Colitis Activity Index), IBD related quality of life (Short Inflammatory Bowel Disease Questionnaire), body image and fatigue (Multidimensional Fatigue Index). The Montreal Index was determined using the medical files of the patients.

Results

The response rate was 24%, with 168 females (F) en 119 males (M). Overall, women and men with IBD did not significantly differ in prevalence of sexual dysfunction from controls: F: 52% versus 44%, M: 25% in both groups. No significant difference in prevalence of depression between patients and controls was observed: F: 16% versus 10%, M: 18% versus 19%. However, females and males with an active disease scored significantly lower on sexual function than patients in remission and controls, indicating impaired sexual functioning. F: 63.1% versus 44.3% p < 0.05, M: 36.1% versus 25.3% p < 0.05. In females with active disease, 25% had a score indicating a depression, 42% in males. This was significantly higher than in controls or patients in remission (F: p < 0.05; p < 0.05, M: p < 0.01; p < 0.001). More patients with an active disease were fatigue, than patients in remission (OR F: 2.7, M: 6.5). There were significant associations between active disease, fatigue, depressive mood, quality of life and sexual function for both male en female patients. Depressive mood was the only factor that significantly contributed to sexual function in both patients and controls (F: p < 0.001, M: p < 0.001).

Conclusion

IBD patients with an active disease show impaired sexual function relative to patients in remission and controls. Depression is an important factor in impaired sexual function in IBD.