Coping strategies, illness perceptions, and relationship dynamics contribute to female sexual function and sexual distress in Sjogren's syndrome

Background
Sexual dysfunction and sexual distress are common complaints for women with the autoimmune rheumatic disease, Sjögren’s syndrome (SS); however, the role of psychosocial and interpersonal factors have not previously been explored in SS.
Aim
This study investigated whether psychosocial variables, such as coping strategies, illness perceptions and relationship dynamics contributed to sexual function and sexual distress for women with SS.
Methods
Participants with SS completed an online cross-sectional survey that included pre-validated questionnaires assessing sexual function, sexual distress, disease-related symptom experiences, cognitive coping strategies, illness perceptions, relationship satisfaction and partners behavioural responses. Multiple linear regression was used to identify factors significantly associated with sexual function (total FSFI score) and sexual distress (total FSDS score) for women with SS.
Outcomes
Study outcome measures included the Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS), EULAR Sjӧgren’s Syndrome Patient Reported Index (ESSPRI), numeric rating scale for vaginal dryness (0-10), Profile of Fatigue and Discomfort (ProFaD), Cognitive Emotion Regulation Questionnaire (CERQ), Brief Illness Perceptions Questionnaire (B-IPQ), West-Haven Yale Multidimensional Pain Inventory (WHYMPI) and Maudsley Marital Questionnaire (MMQ).
Results
A total of 98 cisgender women with SS (M=48.13, SD=13.26) participated in the study. Vaginal dryness was reported by 92.9% of participants, and clinical levels of sexual dysfunction were observed in 85.2% (n=69/81) of cases (total FSFI score <26.55). More vaginal dryness, lower CERQ positive reappraisal and higher CERQ catastrophising were significantly associated with poorer self-rated sexual function (R2=.420, F(3,72)=17.394, p<.001). Higher CERQ rumination, lower CERQ perspective, lower WHYMPI distracting responses and higher B-IPQ identity were significantly associated with higher sexual distress (R2=.631, F(5,83)=28.376, p<.001).
Clinical Implications
This study would suggest that interpersonal and psychosocial factors are important contributors to sexual function and distress in women with SS and that the development of psychosocial interventions for this population is warranted.
Strengths and Limitations
This study is one of the first to explore the impacts of coping strategies, illness perceptions, and relationship dynamics on sexual function and sexual distress for women with SS. Limitations of our study include its cross-sectional nature and limited sample demographic which limit the generalisability of our results to other population groups.
Conclusion
Women with SS who utilised adaptive coping strategies had better sexual function and lower levels of sexual distress than women who utilised maladaptive coping strategies.