Sexual performance in rheumatoid arthritis patients - An unnoticed problem

Rheumatoid arthritis (RA) can influence sexual function due to several reasons, such as pain, restricted joint movements, fatigue, and problems with self-esteem and body image. It can affect serum androgen levels, which may be another cause of sexual dysfunction. Aim of the work: To compare between serum androgen levels in male patients with RA and normal males, and between the presence of erectile dysfunctions (EDs) in both groups. Patients and methods: This study was performed on 42 individuals; 24 male patients suffering from RA and 18 healthy control male subjects. Patients were subjected to full history taking, full locomotor examination, and calculation of disease activity score, using 28 joint count (DAS-28). Assessment of serum dehydro-epiandrosterone sulfate (DHEA), total and free testosterone was done for all subjects. All subjects were asked to complete the Sexual Health Inventory for Men (SHIM). Results: There were highly statistically significant differences in the levels of serum DHEA, total and free testosterone levels between patients and controls (P < 0.001). Occurrence of EDs was more frequent in RA patients (45.8%) than in the control subjects (11.1%) and comparison between SHIM score of both groups revealed highly statistically significant differences (P < 0.001) with higher mean values in the control group. Conclusion: Erectile dysfunction is a prominent problem in male patients with RA. Assessment of sexual functions of RA males should be a part of routine assessment of disease status. Andrological consultation is recommended for a proper management of the condition. (C) 2013 Production and hosting by Elsevier B.V. on behalf of Egyptian Society for Joint Diseases and Arthritis.