Sexual difficulties of chronic pain patients

Objective: Description of the specific physical and psychological problems associated with sexual activity in patients with chronic pain. Design: Self-completion questionnaire on extent and nature of sexual difficulties related to pain: data on psychological and physical function in respondents: personal and medical data for respondents and nonrespondents. Patients: Three hundred twenty-seven patients with chronic pain in inpatient and outpatient pain programs: 237 (72%) completed the questionnaire. Measures: Extent of general and specific sexual problems: anxiety and depression (Hospital Anxiety and Depression Scale [HAD]); pain self-efficacy; pain-related disability (Sickness Impact Profile); drug use. Results: Respondents were younger and had less depressed mood than nonrespondents. but there were no other major differences. Seventy-three percent of respondents had pain-related difficulty with sexual activity; most had several. in various combinations of problems with arousal, position, exacerbating pain, low confidence, performance worries. and relationship problems. All except position difficulties were associated with less frequent sexual activity. There were few differences between men and women, and only weak relations emerged between specific problems and mood and disability. Conclusions: There is a high prevalence of sexual difficulties in patients with chronic pain attending treatment, nearly double that of a general UK survey. These difficulties are not simply related to mood or disability. The range of problems and patients' expressed preferences for help suggest that multidisciplinary intervention is required.