Prevalence and risk factors of sexual problems and sexual distress in a sample of women suffering from chronic widespread pain

Introduction: Chronic widespread pain (CWP) is a prevalent musculoskeletal problem and a cardinal symptom of fibromyalgia, affecting up to 15% of the population. CWP is associated with substantial physical and psychological impairment and reduced quality of life.

Aim: To describe sexual problems in women having CWP. To compare the sexual function between patients with CWP and healthy women, and to explore potential predictors of sexual problems in women suffering from CWP.

Methods: A descriptive, cross sectional study involving a total of 853 individuals, including 166 with CWP and 687 healthy counterparts. For the screening of sexual problems and distress, the original and amended lifelong version of the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale were applied. A set of standardized questionnaires to assess potential risk factors for sexual problems was further used.

Main outcome measures: The levels of sexual function and distress in women with CWP was compared with those of healthy women. Univariate and multivariate linear regression was used to determine the potential predictors for sexual problems in women with CWP and healthy counterparts.

Results: Women with CWP reported more difficulties with lubrication, more sexual pain, and higher levels of sexual distress. Potential predictors of sexual problems in women with CWP were heterogeneous, with relationship dissatisfaction being associated with lower levels of sexual function in all the FSFI domains. Significant, domain-specific effects were further detected for anxiety sensitivity, emotional intelligence, obsessive compulsive behavior, and the big five personality traits. In general, factors influencing recent sexual problems were different from those influencing lifelong sexual function.

Conclusions: CWP patients report more sexual pain and sexual distress compared with controls. Assessment of sexual problems should therefore be added to routine care of patients with CWP.