Sexual dysfunction in patients with inflammatory bowel disease

Introduction
Inflammatory bowel diseases (IBD) significantly influence sexual function due to their symptoms. The impact of the disease on sexuality and intimacy is a predominant concern for IBD patients, though data on sexual (SD) and erectile dysfunction (ED) and their determinants remain scarce.

Aim
The aim of this study was to evaluate sexual function and identify predictors of SD among patients with IBD during biological treatment.

Material and methods
This prospective study included 135 adult patients with Crohn’s disease (n = 106) and ulcerative colitis (n = 29) who were selected for biological treatment based on established criteria (CD: CDAI > 300; UC: Total Mayo score > 6). Participants completed validated questionnaires on their sexual function: the Female Sexual Function Index (FSFI) and the International Index of Erectile Function-5 (IIEF-5), with a question from the Inflammatory Bowel Disease Questionnaire (IBDQ).

Results
43.7% of patients reported SD, with similar proportions in men and women (p = 0.536). There was no significant correlation between the duration of IBD, type of medication or calprotectin levels and the results of the FSFI and IIEF-5 questionnaires. Self-reported limitations were greater for women compared to men (p < 0.001), with a significant correlation between them and both IIEF-5 and FSFI scores across both disease types (p < 0.001).

Conclusions
SD and ED among patients treated with biologics were associated with psychological factors but not disease severity. The type of medication used to treat the underlying disease did not influence the development of SD. These findings underscore the need for a comprehensive understanding of sexual health and psychological support for IBD patients.