Self-esteem as a determinant of sexual function in systemic lupus erythematosus patients: a cross-sectional study

Background The correlation between self-esteem and sexual function in systemic lupus erythematosus (SLE) patients remains unexplored. The objective was to assess the association between body self-esteem, global self-esteem, and sexual function in patients with SLE. Methods A cross-sectional study was conducted at a tertiary care center. We included patients aged 18 and older who met the EULAR/ACR criteria for SLE. Body self-esteem was measured using the Body Self-Esteem Scale (BSES), while global self-esteem was assessed with the Rosenberg Self-Esteem Scale (RSE). Sexual function was evaluated using the Changes in Sexual Functioning Questionnaire Short-Form questionnaire (CSFQ-14). Sexual dysfunction (SD) was defined as a total CSFQ-14 score of less than 41 points for women and less than 47 points for men. We assessed disease activity using the SLEDAI-2 K, and damage accrual with the SLICC damage index. Results A total of 280 patients were included, the majority of whom were female (88.6%). The median age was 39 years (IQR 31 to 49). The median SLEDAI-2 K score was 2 (IQR 0 to 4), and the SLICC damage index was 0 (IQR 0 to 1). A total of 147 patients (52.5%) were classified as having SD. The BSES score showed a significant correlation with the total CSFQ-14 score (rho = 0.364, p < 0.001). Similarly, the RSE subcomponents, self-competence (rho = 0.262, p < 0.001) and self-liking (rho = 0.274, p < 0.001) showed both a significant positive correlation with the total CSFQ-14 score. Patients with SD compared to those without SD had significantly lower BSES scores, lower self-competence scores and lower self-liking scores. Female sex (OR 2.6, 95% CI 1.2 to 6.0, p = 0.026), lower leukocyte count (OR 1.2, 95% CI 1.0 to 1.3, p = 0.046), and lower BSES score (OR 1.9, 95% CI 1.8 to 2.1, p < 0.001) were independent risk factors for sexual dysfunction. Conclusions This is the first study to evaluate self-esteem as a determinant of sexual function in SLE patients. Given the significant impact of self-esteem on sexual dysfunction, its relationship should be assessed during rheumatology evaluations. Clinical trial number Not applicable.