Over the past 10 years, several studies have focused on sexuality in patients with Crohn’s disease. Very few of them specifically focused on perianal disease (PD). This study aimed to compare the prevalence of sexual dysfunction (SD) in Crohn’s disease patients with active PD versus controls without active PD.
Patients from 14 French centers with active PD, defined by the presence of symptomatic ulceration, fistula, or stenosis, were arbitrarily included. They were compared to controls from the existing SEXIA cohort. Men completed the International Index of Erectile Function (IIEF) and women, the Female Sexual Function Index (FSFI). The primary endpoint was SD defined by an FSFI <26.55 in women and an IIEF <42.9 in men.
Ninety-seven patients (64 women, 33 men) and 238 controls (131 women, 107 men) were included. SD was found in 66% of the female patients versus 50% of the controls (p = 0.04). In the male population, SD was found in 30% of the cases versus 16% of the controls (p = 0.06). Erectile dysfunction affected 46% of the male patients and 43% of the controls (p = 0.8). On multivariate analysis, the predictive factor most strongly associated with SD in women was severely active anal-PD defined by a perineal disease activity index >4 (OR = 13.05 [2.32-73.44]).
Women with active PD had an increased prevalence of SD compared to controls without active PD. In the male population, the study was unable to determine if there was a difference as it was underpowered.

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