Kenneth M. Peters MD, Donna J. Carrico NP, MS, Kim A. Killinger NP, MSN, Ibrahim A. Ibrahim MD, MPH, PhD, Ananias C. Diokno MD

William Beaumont Hospital-Royal Oak, MI; Alessandra Graziottin, H. San Raffaele Resnati, Milan, Italy

Introduction and Objective: Few researchers examine female sexual dysfunction (FSD) and sexual distress in women with Interstitial Cystitis (IC). Some studies report dyspareunia or alterations in quality of life in women with IC, but specific areas of FSD have not been reported. The objective was to evaluate FSD and sexual distress in women with IC vs. a control group.

Methods: A mailed survey developed by the investigators was sent to 5000 randomly selected women from the United States (controls) and 407 women diagnosed with IC from a large referral center (cases). A total of 215 women with IC (53%) and 823 (16%) of the control group responded. This comprehensive survey utilized the validated Female Sexual Distress Scale (FSDS) and additional questions about sexual function, desire, orgasm and pain to explore the multiple dimensions of FSD. Student t-test was used to compare means and chi-square was used to compare proportions between cases and controls.

Results: The two groups were similar with respect to age, ethnicity and educational level. All of the cases and 98.4% of the controls stated they had sexual intercourse during adolescence and their levels of sexual desire and frequency of orgasm did not differ significantly. However, a higher proportion of the women with IC reported they had fear of pain and actually had pain with intercourse than controls in adolescence (32.5% and 18.5%, respectively). This difference was statistically significant (OR 1.76 CI 1.19 – 2.59).

In adulthood, sexual activity was similar for cases (79.1%) and controls (78.5%).

A significantly higher proportion of women with IC (67.18%) vs. controls (18%) reported having pelvic pain (OR 3.75 CI 3.1-4.5). Fear of having pain during sexual intercourse was reported significantly more by cases (61.0%) than controls (17.3%) and dyspareunia was reported more by cases (74.6%) than controls (30%).

BEFORE the diagnosis of IC, 86% of cases reported moderate or high sexual desire compared to 78% of the controls (p=0.016). AFTER the IC diagnosis, the number of cases reporting moderate-high sexual desire declined significantly from 86% to 40% (p<0.00). BEFORE IC, the frequency rates of orgasm in both groups (frequently or very frequently) was similar (Cases=63%; Controls=61%). AFTER IC, this rate decreased to 44% in cases (p< 0.00).

The mean value of the FSDS was statistically significant. It was higher among established IC cases (18.5) compared to controls (8.3) (p<0.000). A score ≥ 15 on the FSDS is associated with sexual distress.

Conclusions: Women with IC have significantly more alterations in sexual function and more sexual distress than women without IC. Pelvic pain and dyspareunia is prevalent in women with IC and should not be ignored in clinical practice. In addition, sexual desire and the frequency of intercourse and orgasm significantly declined after their diagnosis of IC. Further study is needed to evaluate sexual dysfunction and sexual distress in women with IC in order to provide more comprehensive care to these women to improve their quality of life.

UroToday.com Coverage of SUFU 2007

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