Ankylosing spondylitis and its impact on sexual relationships

Objective. To explore the impact of AS on the sexual relationships of a large cohort of patients, across the UK. Methods. A total of 1000 patients with a confirmed diagnosis of AS under the clinical care of 10 specialist rheumatology centres across the UK were invited to participate in a study evaluating a new quality of life measure. Patients completed a questionnaire, which also included questions relating to the impact of AS on their sexual relationships, sociodemographic and clinical characteristics. Results. Six hundred and twelve (64%) patients took part in the study. The majority were male (71.6%), mean age 50.8 +/- 12.2 years, mean diagnosed disease duration 17.3 +/- 11.7 years and mean symptom duration 23 +/- 18.6 years. Of those who responded to the question on sexual relationships (n = 552), 210 (38.0%) reported that their sexual relationships were affected 'moderately', 'quite a bit' or 'extremely' by their AS. Males reported greater sexual problems with increasing age. Poor function [odds ratio (OR) 3.64; 95% Cl 1.92, 6.87], depression (OR 2.03; 95% Cl 1.21, 3.41), greater disease activity (OR 2.10; 95% Cl 1.01, 4.40), unemployment (OR 1.99; 95% Cl 1.16, 3.40) and poor self-efficacy (OR 1.25; 95% Cl 1.09, 1.43) were independently associated with a greater impact on patients' sexual relationships. Conclusion. AS has a substantial impact on patients' sexual relationships. Management of AS and its impact on sexual relationships should be directed not only towards physical outcomes such as disease activity and physical function, but also take into consideration the psychological state of the patient.