Main Article Content
The sexual life of women with chronic obstructive pulmonary disease (COPD) can be affected by breathing difficulties, decreased functional status, depressive mood and fatigue.
To evaluate the sexual dysfunction in female COPD patients and the possible explanatory mechanisms or correlations between these conditions.
Methods: The study included 70 female patients with COPD aged between 36-65 and 70 age-matched controls. All the subjects completed questionnaires for the Female Sexual Functional Index (FSFI), BECK depression inventory and spirometry.
Statistically significant sexual dysfunction was noted in COPD patients compared to the non-COPD group (p<0.001). BECK depression inventory scores of the COPD patients were also significantly lower (p><0.001). no correlation between FSFI and BECK depression scores in 'patients' characteristics (r=-0.055, p=0.651). No significant difference was found in age, forced expiratory volume (FEV)1%, and exacerbation history of the previous year according to severity of depression (p>0.005). In linear regression analysis determining depression, no statistically significant factor was found among age, number of comorbidities, and FEV1/ forced vital capacity (FVC) % predicted (p>0.05). In multivariable analysis, only fatigue during intercourse was found to be a statistically significant factor in predicting sexual dysfunction among factors like age, presence of comorbidities, duration of the disease, smoking status, FEV1%, m MRCpoints, 6-minutes walk test, BECK depression scores (p=0.008).
Sexual dysfunction is reported in many COPD females and seems to be related not to spirometric measures or exercise capacity but to fatigue. Depression is also a common comorbidity, of which both disorders are often neglected.
GOLD Assembly. Global Strategy for the Diagnosis, Management, and Prevention of COPD; 2023. https://goldcopd.org/2023-gold-report-2/
Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PloS Med. 2006; 3(11): e442. https://doi.org/10.1371/journal.pmed.0030442 PMid:17132052 PMCid:PMC1664601
Halpin DMG, Celli BR, Criner GJ, Frith P, López VMV, Salvi S, et al. It is time for the world to take COPD seriously: a statement from the GOLD board of directors. Eur respir J. 2019; 54(1): 1900914. https://doi.org/10.1183/13993003.00914-2019 PMid:31273036
Han MK, Agusti A, Celli BR, Criner GJ, Halpin DMG, Roche N, et al. From GOLD 0 to Pre-COPD. Am J Respir Critical Care Med. 2021; 203(4): 414-23. https://doi.org/10.1164/rccm.202008-3328PP PMid:33211970 PMCid:PMC7885837
Celli B, Fabbri L, Criner G, Martinez FJ, Mannino D, Vogelmeier C, et al. Definition and Nomenclature of COPD: Time for its Revision.Am J Respir Crit Care Med. 2022; 206(11):1317-1325. https://doi.org/10.1164/rccm.202204-0671PP PMid:35914087 PMCid:PMC9746870
World Health Organization. Definiton of sexual health. https://www.who.int/health-topics/sexual-health#tab=tab_2
Levack WMM, Poot B, Weatherall M, Travers J,Cochrane Airways Group. Interventions for sexual dysfunction in people with chronic obstructive pulmonary disease (COPD). Cochrane Database of Systematic Reviews. 2015; 2015(9): CD011442. https://doi.org/10.1002/14651858.CD011442.pub2
Macêdo TE, da Silva G, Morano MT, Alcântara HM, Delgado PE. Sexuality and Associated Factors in Chronic Obstructive Pulmonary Disease (COPD) Patients Attending a Referral Hospital in Northeastern Brazil. J Sex Marital Therapy. 2021; 47:3: 253-261, https://doi.org/10.1080/0092623X.2020.1869124 PMid:33403923
Kaplan SE, Dai NA, Gümüssoy S. Relationship between the symptoms of COPD and the quality of sexual life. Sex Disab. 2022; 40(3): 555-565. https://doi.org/10.1007/s11195-022-09744-0 PMid:35811840 PMCid:PMC9252539
Zysman M, Rubenstein J, Le Guillou F, Colson RHM, Pochulu C, Grassion L, et al. "COPD burden on sexual wellbeing." Respir Res. 2020; 21(1): 311. https://doi.org/10.1186/s12931-020-01572-0 PMid:33238993 PMCid:PMC7687801
Kaptein AA, van Klink RCJ, de Kok F, Scharloo M, Snoei L, Broadbent E, Bel EHD, et al. Sexuality in patients with asthma and COPD. Respiratory Med. 2008: 102(2): 198-204. https://doi.org/10.1016/j.rmed.2007.09.012 PMid:17996435
Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL, et al. Standardization of spirometry 2019 update. An official American thoracic society and European respiratory society technical statement. Am J Respir Crit Care Med. 2019; 200(8): e70-e88. https://doi.org/10.1164/rccm.201908-1590ST PMid:31613151 PMCid:PMC6794117
Yorgancioglu A, Polatli M, Aydemir O. Reliability and validity of Turkish version of COPD assessment test.Tuberk Toraks. 2012; 60(4): 314-320. https://doi.org/10.5578/tt.4321 PMid:23289460
ATS Committee on Proficiency Standards for Clinical Function Laboratories. American Thoracic Society Statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002; 166: 111-117. https://doi.org/10.1164/ajrccm.166.1.at1102 PMid:12091180
Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, et al. The body mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004; 350: 1005-1012 https://doi.org/10.1056/NEJMoa021322 PMid:14999112
Jackson-Koku G. Beck depression inventory. Occupat Med. 2016; 66(2): 174-175. https://doi.org/10.1093/occmed/kqv087 PMid:26892598
Rosen C, Brown JH, Leiblum S, Meston C, Shabsigh R, Ferguson D, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2011; 26(2): 191-208. https://doi.org/10.1080/009262300278597 PMid:10782451
Abd-Elsalam F, Mahgoub N. Chronic obstructive pulmonary disease and sexual functioning among women in egypt egyptian. J Chest Dis Tuberculosis 2015; 64: 551-6. https://doi.org/10.1016/j.ejcdt.2015.02.006
Crisafulli E, Clini EM. Measures of dyspnea in pulmonary rehabilitation. Multidiscip Respir Med. 2010; 5(3):1-9. https://doi.org/10.1186/2049-6958-5-3-202 PMid:22958431 PMCid:PMC3463047
Denis E, Milne KM, James MD, de Torres JP, Neder JA. Dyspnea in COPD: new mechanistic insights and management implications. Adv Ther. 2020; 37(1): 41-60. https://doi.org/10.1007/s12325-019-01128-9 PMid:31673990 PMCid:PMC6979461
Schonhofer B, von Sydow K, Bucher T, Nietsch M, Suchi S, Köhler D, et al. Sexuality in patients with noninvasive mechanical ventilation due to chronic respiratory failure. Am J Respirat Crit Care Med. 2001; 164(9): 1612-1617. https://doi.org/10.1164/ajrccm.164.9.2103020 PMid:11719298
Farver-Vestergaard I, Frederiksen Y, Zachariae R, Rubio-Rask S, Løkke A. Sexual health in COPD: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2022; 17: 297-315. https://doi.org/10.2147/COPD.S347578 PMid:35173430 PMCid:PMC8842639
Polland A, Davis M, Zeymo Z, Venkatesan K. Comparison of correlated comorbidities in male and female sexual dysfunction: findings from the third national survey of sexual attitudes and lifestyles (Natsal-3). J Sex Med. 2018; 15(5): 678-686. https://doi.org/10.1016/j.jsxm.2018.02.023 PMid:29631956
Kinsman RA, Yaroush RA, Fernandez E, Dirks JF, Schocket M, Fukuhara J. Symptoms and experiences in chronic bronchitis and emphysema. Chest. 1983; 83(5): 755-761. https://doi.org/10.1378/chest.83.5.755 PMid:6839816
Reda M, Ruby D. Female Sexual Dysfunction Among a Sample of Egyptian Patients with Asthma. Open Respir Med J. 2020; 14: 38-44. https://doi.org/10.2174/1874306402014010038 PMid:33299491 PMCid:PMC7705956
Schütt CB, Grønbaek M, Osler M, Vestergaard PB, Graugaard C, Frisch M. Associations between physical and mental health problems and sexual dysfunctions in sexually active Danes. J Sex Med. 2011; 8(7): 1890- 902. https://doi.org/10.1111/j.1743-6109.2010.02145.x PMid:21176110
Di Marco F, Verga M, Reggente M, Casanova FM, Santus P, Blasi F, et al. Anxiety and depression in COPD patients: the roles of gender and disease severity. Respiratory Med. 2006; 100(10): 1767-1774. https://doi.org/10.1016/j.rmed.2006.01.026 PMid:16531031
Mengistu YA, Mülerová H, Lavoie K, Vestbo J, Rennard SI, Wouters E, et al. The association of depressive symptoms with rates of acute exacerbations in patients with COPD: results from a 3-year longitudinal follow-up of the ECLIPSE cohort. J Am Med Dir Assoc. 2017; 18(11): 955-959.e6. https://doi.org/10.1016/j.jamda.2017.05.024 PMid:28733182
Theander K, Unosson M. Fatigue in patients with chronic obstructive pulmonary disease. J Adv Nurs. 2004; 45(2): 172-7. https://doi.org/10.1046/j.1365-2648.2003.02878.x PMid:14706002
Kapella MC, Larson JL, Patel MK, Covey MK, Berry JK. Subjective fatigue, influencing variables, and consequences in chronic obstructive pulmonary disease. Nurs Res. 2006; 55(1): 10-7. https://doi.org/10.1097/00006199-200601000-00002 PMid:16439924
Mikael A, Stridsman C, Rönmark E, Lindberg A, Emtner M. Physical activity and fatigue in chronic obstructive pulmonary disease-a population-based study. Respir Med. 2015;109(8): 1048-57. https://doi.org/10.1016/j.rmed.2015.05.007 PMid:26070272
Panagioti M, Scott C, Blakemore A, Coventry PA. Overview of the prevalence, impact, and management of depression and anxiety in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2014; 9:1289-306. https://doi.org/10.2147/COPD.S72073 PMid:25419126 PMCid:PMC4235478
Geraghty AC, Kaufer D. Glucocorticoid regulation of reproduction. In: Wang J-G, Harris C. Glucocorticoid Signaling: From Molecules to Mice to Man. Advances in Experimental Medicine and Biology. Springer; 2015. 253-278. https://doi.org/10.1007/978-1-4939-2895-8_11 PMid:26215998
Levack W. Sexual wellbeing for people with chronic obstructive pulmonary disease: relevance and roles for physiotherapy. New Zeal J Physiother. 2014; 42(3):154-161. https://doi.org/10.15619/NZJP/42.3.08
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The copy rights of the articles published in Colombia Médica belong to the Universidad del Valle. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Colombia Médica without prior authorization for non-commercial use