Comprehensive self-management reduces the negative impact of irritable bowel syndrome symptoms on sexual functioning

Abstract

Background: Women with irritable bowel syndrome (IBS) report sexual dysfunction. Comprehensive self-management (CSM) intervention has been shown to reduce gastrointestinal, psychological, and somatic symptoms in IBS women. Whether this intervention also reduces sexual dysfunction is not known.

Aims: We sought to compare demographic and clinical factors in IBS women with and without sexual dysfunction as defined by the Arizona sexual experiences scale (ASEX) and to test the effects of CSM treatment on sexual dysfunction scores and on the sexual relations subscale of an IBS quality of life (IBSQOL) scale which measures the effect of IBS on sexual QOL.

Methods: IBS (Rome II) women enrolled in a randomized clinical trial of CSM treatment were characterized as having sexual dysfunction (N = 89) or not (N = 86) at baseline based on ASEX criteria. Baseline characteristics and symptoms were compared between the two groups. Post-intervention changes were compared between the CSM and the usual care arms of the randomized trial.

Results: Women meeting ASEX criteria for sexual dysfunction were older, had higher lifetime depression and antidepressant use, more primary care/MD visits, fewer mental healthcare visits, and greater sleep disturbance than those without sexual dysfunction. No significant group differences in gastrointestinal or somatic symptoms were observed. Compared with usual care treatment, CSM increased sexual QOL scores and had a weaker effect on ASEX scores.

Conclusions: Severity of IBS symptoms at baseline did not differ between IBS women with or without sexual dysfunction. The CSM intervention can reduce the effect of IBS on sexual QOL.

Figures

Figure 1

The effect of CSM treatment on the sexual relations subscale of the IBSQOL [9 weeks (N=79), 6 months (N=78), 12 months (N=73)]. A positive value corresponds to improvement. CSM - Comprehensive Self Management, IBSQOL – Irritable Bowel Syndrome Quality of Life Scale, UC – Usual Care group.

Figure 2

Change in Arizona Sexual Experiences Scale (ASEX) scores with Comprehensive Self-management (CSM) or Usual Care (UC). A. This depicts all women with IBS who filled out ASEX at different time points and their changes of ASEX scores from baseline [9 weeks (N=127), 6 months (N=126), 12 months (N=125)]. B. This depicts all women with IBS who filled out ASEX but also reported that they were sexually active at baseline and at follow up [9 weeks (N=79), 6 months (N=78), 12 months (N=73)]. A negative value corresponds to improvement.