By Will Boggs MD
NEW YORK (Reuters Health) - Men and women with inflammatory bowel disease (IBD) have a significantly increased risk of sexual dysfunction, according to a new meta-analysis.
"As people get older, the prevalence of sexual dysfunction increases due to disturbance of hormones," said Dr. Zhigang Zhao from The First Affiliated Hospital of Guangzhou Medical University, in Guangzhou, China.
"Inversely, however, our study, which combined the relative risk from 8 relevant studies, indicated both male and female inﬂammatory bowel diseases patients with a younger age exhibited significantly increased odds of sexual dysfunction when compared to the healthy subjects, but such association was not found in a relatively older age in both sexes," he told Reuters Health by email.
Previous studies have reported sexual dysfunction rates ranging from 44% to 53.9% in patients with IBD, with higher rates in women (66%) than in men (40%), but controversy remains regarding the association between IBD and sexual dysfunction.
To investigate, Dr. Zhao's team conducted a meta-analysis of eight studies including more than 351,000 men and 1,309 women ranging in mean age from 33.6 years to 52.4 years.
Among men, 11.7% of those with IBD had sexual dysfunction, compared with 9.7% of those without IBD, a difference of 40 more men per 1,000, the researchers report in Inflammatory Bowel Diseases, online November 23.
Similarly, 44.9% of women with IBD had sexual dysfunction, compared with 24.0% of women without IBD, a difference of 182 more women per 1,000.
IBD was associated with a 41% increased risk of sexual dysfunction in men and a 76% increased risk in women.
IBD was associated with significantly greater odds of sexual dysfunction among men younger than 50 years and women younger than 40 years, but there was no association between IBD and sexual dysfunction for men 50 and older or women 40 and older.
"The etiologies of sexual dysfunction in inﬂammatory bowel diseases patients may be multifactorial, including but not limited to the nature of disease (activity, severity, and duration), pelvic floor disorders, psychosocial factors, body image perceptions and changes, medications usage, hypogonadism, and surgical interventions," Dr. Zhao said.
"Accordingly, those patients with inﬂammatory bowel diseases who complained about sexual dysfunction may benefit from controlling the disease itself, treating pelvic floor disorders and psychosocial conditions, envisaging reality of the disease and being more confident, treating hypogonadism, and selecting the proper surgery," he said.
Dr. Zhao added, "Additional high-quality stringent cohort studies with large sample size are still warranted to elucidate the relationship between inﬂammatory bowel diseases and the risk of sexual dysfunction in both sexes."
Dr. Sonia Friedman from Harvard Medical School and Brigham and Women's Hospital, in Boston, who wrote an accompanying editorial, told Reuters Health by email, "Sexual dysfunction in IBD patients is quite common, but few physicians ask their patients about it. Most patients feel comfortable with and would like to discuss this with their physicians (regardless of patient gender or physician gender)."
"Ask IBD patients about sexual function; if yes, figure out cause and treat or refer for treatment," she said. "Evaluate for depression, IBD activity, hypogonadism, pelvic floor dysfunction in women, and medications - specifically steroids, anti-depressants, and narcotics. For men, check testosterone and have them see a urologist."
SOURCE: https://bit.ly/2BVeYBD and https://bit.ly/2AUwdRT
Inflamm Bowel Dis 2018.
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