Evaluation of sexual dysfunction among women with primary Sjögren's syndrome using a Female Sexual Function Index: a systematic review and meta-analysis

Background Only a few studies have assessed sexual dysfunction in women with primary Sj & ouml;gren's syndrome (pSS).Aim We aimed to confirm the higher prevalence of sexual dysfunction in these women and identify the most impaired domain of sexual function and the risk factors associated with it.Methods We conducted a systematic review and meta-analysis to investigate the risk of sexual dysfunction in women with pSS according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The study protocol has been registered in the "PROSPERO international prospective register of systematic reviews" with the registration number CRD42022298525.Outcomes We aimed to compare sexual dysfunction among women with pSS compared to healthy subjects and which domain of the Female Sexual Function Index (FSFI) was most impaired.Results In the analysis involving 16 studies, pSS is associated with 5-fold higher odds of reporting sexual dysfunction compared to the control group. Additionally, differences in FSFI scores between pSS and healthy controls were found to be statistically significant. All FSFI item sub-scores were affected by pSS more than the control group.Clinical Implications Sexual dysfunction is common in pSS and needs to be evaluated in all women with pSS.Strengths and Limitations This is the first meta-analysis that emphasized that sexual dysfunction in women with pSS should be evaluated regardless vaginal dryness. Nevertheless, caution is required when interpreting results due to the poor quality of the selected studies.Conclusion The sexual dysfunction was a common issue in pSS with various causes and should be addressed by healthcare providers.