Sexual and mental health of woman suffering from selected connective tissue diseases: an original paper



The aim of the study was to assess the sexual and mental health of women suffering from connective tissue diseases and to determine the potential interrelationships between the studied clinical variables and sexual and mental health.


The study was conducted in a group of women with connective tissue diseases. To assess somatic health, we used The Health Assessment Questionnaire (HAQ-DI), and to assess sexual health, we used the Female Sexual Function Index (FSFI) and Sexual Satisfaction Questionnaire (KSS). The mental health was assessed by using the Hospital Anxiety and Depression Scale (HADS-M) and the PERMA-Profiler (PL).


The study involved 81 women suffering from connective tissue diseases, especially rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS) and juvenile idiopathic arthritis (JIA). Clinical symptoms of sexual dysfunction were observed in 54% women. The biggest difficulties occur in sexual desire, orgasm and arousal. Patients had symptoms of anxiety and depressive disorders. Higher levels of anxiety and depression are associated with poorer overall sexual functioning and better overall sexual functioning, and all its dimensions are associated with a higher level of mental well-being. There was also an observed relationship with the functional limitation due to pain and duration of the disease.


The study confirms the existence of difficulties in the sexual functioning of women suffering from connective tissue diseases and shows the relationship between sexual and mental health and basic disease. The observed relationships are important information in the treatment and medical care of people with this group of rheumatic diseases.

Key Points
• The article presents one of the few studies about sexual functioning of Polish population women with connective tissue diseases.
• The aim was to assess the sexual and mental health of women with various connective tissue diseases and determine the potential interrelationships between the clinical variables and sexual and mental health.
• The study confirms difficulties in the sexual functioning of women with connective tissue diseases. The biggest difficulties occur in sexual desire, orgasm and arousal. Patients also had mental disorders symptoms.
• The study presents conclusions and indications which may be important and help specialists approach the treatment process in an interdisciplinary way.

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Fig. 1

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.


  1. 1.

    Kismödi E, Corona E, Maticka-Tyndale E, Rubio-Aurioles E, Coleman E (2017) Sexual rights as human rights: a guide for the WAS declaration of sexual rights. Int J Sex Health 29(1):1–92

    Article  Google Scholar 

  2. 2.

    WHO (2006) Defining sexual health: report of a technical consultation on sexual health, 28–31 January 2002. World Health Organization, Geneva

    Google Scholar 

  3. 3.

    Imieliński K (1986) Zarys seksuologii i seksiatrii. Państwowy Zakład Wydawnict Lekarskich, Warsaw

    Google Scholar 

  4. 4.

    Ziherl S, Masten R (2010) Differences in predictors of sexual satisfaction and in sexual satisfaction between female and male university students in Slovenia. Psychiatr Danub 22:425–429

    PubMed  Google Scholar 

  5. 5.

    Dorner TE, Berner C, Haider S, Grabovac I, Lamprecht T, Fenzl KH, Erlacher L (2018) Sexual health in patients with rheumatoid arthritis and the association between physical fitness and sexual function: a cross-sectional study. Rheumatol Int 38(6):1103–1114

    Article  Google Scholar 

  6. 6.

    Alia F, Rim BS, Miladi S, Ouenniche K, Kassab S, Chekili S, Zakraoui L, Abdelghani KB, Laatar A (2019) Comparison of sexual function in Tunisian women with rheumatoid arthritis and healthy controls. Clin Rheumatol 38(12):3361–3365

    Article  Google Scholar 

  7. 7.

    Coskun B, Coskun BN, Atis G, Ergenekon E, Dilek K (2014) Evaluation of sexual function in women with rheumatoid arthritis. Urol J 10(4):1081–1087

    PubMed  Google Scholar 

  8. 8.

    Tristano AG (2009) The impact of rheumatic diseases on sexual function. Rheumatol Int 29(8):853–860

    Article  Google Scholar 

  9. 9.

    Morales MG, Rubio JC, Peralta-Ramirez MI, Romero LH, Fernández RR, García MC, Centeno NO (2013) Impaired sexual function in women with systemic lupus erythematosus: a cross-sectional study. Lupus 22(10):987–995

    Article  Google Scholar 

  10. 10.

    Hong P, Pope JE, Ouimet JM, Rullan E, Seibold JR (2004) Erectile dysfunction associated with scleroderma: a case-control study of men with scleroderma and rheumatoid arthritis. J Rheumatol 31(3):508–513

    PubMed  Google Scholar 

  11. 11.

    WHO (2006) Promoting mental health: concepts, emerging evidence, practice. World Health Organization, Geneva

    Google Scholar 

  12. 12.

    Kluczyńska S (2015) Zdrowie psychiczne – wybrane definicje i koncepcje wyjaśniające. In: Zdrowie psychiczne młodych dorosłych. Wybrane zagadnienia. Difin S.A, Warsaw, pp 25–39

    Google Scholar 

  13. 13.

    Seligman MEP (2011) Pełnia życia. Nowe spojrzenia na kwestie szczęścia i dobrego życia. Media Rodzina, Poznań

    Google Scholar 

  14. 14.

    Jasiewicz A, Samochowiec J (2011) Zaburzenia psychiczne w chorobach tkanki łącznej. Psychiatria 8:39–45

    Google Scholar 

  15. 15.

    Fries JF (2009) The health assessment questionnaire (HAQ) and the improved HAQ. Standford University School of Medicine Division of Immunology & Rheumatology, Standford

    Google Scholar 

  16. 16.

    Nowosielski K, Wróbel B, Sioma-Markowska U, Poręba R (2014) Development and validation of the Polish version of the Female Sexual Function Index in the Polish population of females. J Sex Med 10:386–395

    Article  Google Scholar 

  17. 17.

    Rosen C, Brown J, Heiman S et al (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26:191–208

    CAS  Article  Google Scholar 

  18. 18.

    Nomejko A, Dolińska-Zygmunt G (2014) The Sexual Satisfaction Questionnaire – psychometric properties. Polish J Appl Psychol 12:105–112

    Article  Google Scholar 

  19. 19.

    Butler J, Kern ML (2016) The PERMA-Profiler: a brief multidimensional measure of flourishing. Int J Wellbeing 6:1–48

    Article  Google Scholar 

  20. 20.

    Majkowicz M (2000) Praktyczna ocena efektywności opieki paliatywnej – wybrane techniki badawcze. In: Majkowicz M, de Walden-Gałuszko K (eds) Ocena jakości opieki paliatywnej w teorii i praktyce. Akademia Medyczna, Zakład Medycyny Paliatywnej, Gdańsk, pp 21–42

    Google Scholar 

  21. 21.

    Ehrlich GE (1983) Social, economic, psychologic, and sexual outcomes in rheumatoid arthritis. Am J Med 75:27–34

    CAS  Article  Google Scholar 

  22. 22.

    Yoshino S, Uchida S (1981) Sexual problems of woman with rheumatoid arthritis. Arch Phys Med Rehabil 62:122–123

    CAS  PubMed  Google Scholar 

  23. 23.

    Kossakowska AB (2004) Objawy depresji u osób z reumatoidalnym zapaleniem stawów. Doctoral dissertation. Akademia Medyczna w Białymstoku, Białystok

    Google Scholar 

  24. 24.

    Kwiatkowska B, Przygodzka M, Konopińska E et al (2011) Depresja u chorych na reumatoidalne zapalenie stawów. Reumatologia 49:138–141

    Google Scholar 

  25. 25.

    Dregan A, Matcham F, Harber-Aschan L, Rayner L, Brailean A, Davis K, Hatch S, Pariante C, Armstrong D, Stewart R, Hotopf M (2019) Common mental disorders within chronic inflammatory disorders: a primary care database prospective investigation. Ann Rheum Dis 78:688–695

    Article  Google Scholar 

  26. 26.

    Gałecki P, Talarowska M (2018) Inflammatory theory of depression. Psychiatr Pol 52(3):437–447

    Article  Google Scholar 

  27. 27.

    Wasilewski D, Wojnar M, Chatizow J (2010) Depresja a ból: ogólnopolskie badanie epidemiologiczne. Psychiatr Pol 44:435–445

    PubMed  Google Scholar 

  28. 28.

    Poprawa R (2001) Zasoby osobiste w radzeniu sobie ze stresem. In: Dolińska-Zygmunt G (ed) Elementy psychologii zdrowia. Wydawnictwo Uniwersytetu Wrocławskiego, Wrocław, pp 103–141

    Google Scholar 

  29. 29.

    Rosen RC, Bachmann GA (2008) Sexual well-being, happiness and satisfaction, in woman: the case for a new conceptual paradigm. J Sex Marital Ther 34:291–297

    Article  Google Scholar 

  30. 30.

    Vigl M, Hager A, Bauer U, Niggemeyer E, Wittstock B, Kohn FM, Hess J, Kaemmerer H (2009) Sexuality and subjective wellbeing in male patients with congenital heart disease. Heart 95:1179–1183

    CAS  Article  Google Scholar 

  31. 31.

    Bossini L, Fortini V, Casolaro I et al (2014) Sexual dysfunctions, psychiatric diseases and quality of live: a review. Psychiatr Pol 48:715–726

    PubMed  Google Scholar 

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Correspondence to Michał Wiśniewski.

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Wiśniewski, M., Zabłocka-Żytka, L. Sexual and mental health of woman suffering from selected connective tissue diseases: an original paper. Clin Rheumatol (2021).

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  • Anxiety
  • Connective tissue diseases
  • Mental health
  • Sexual functioning
  • Sexual health