Quality of Sex Life in Patients with Inflammatory Bowel Disease

To the Editor: Sexual function, one determinant of quality of life according to the WHO,1 has been poorly explored so far in inflammatory bowel disease (IBD). Around 50% of women with IBD experience sexual dysfunction, whereas 40% of men suffer from erectile dysfunction.2,3 No data are available on how frequently IBD-treating physicians approach this topic with patients. This study aimed to ascertain the proportion of them addressing this issue and to determine reasons for not doing so. An anonymous self-administrated questionnaire was proposed to gastroenterologists participating in an IBD postgraduate meeting organized by a regional association of gastroenterologists in Bordeaux (France). Two months later, an online version of the questionnaire was sent using the association's mailing list. Characteristics of the participants are described in Table 1. Description of the Participants to the IBD Postgraduate Meeting Description of the Participants to the IBD Postgraduate Meeting Eighty-four percent of physicians never (17 [25%]) or rarely (41 [59%]) addressed the topic of sexuality with their IBD patients, whereas 16% tackled the subject often (9 [13%]) or always (2 [3%]). Proctology as main practice was associated with addressing the topic often or always (odds ratio 11.3 [confidence interval 95% 2.6–55.0], P < 0.01), sex and age of the gastroenterologist were not (P = 0.68 and P = 0.12 respectively). Ninety-three percent of physicians (64) thought gastroenterologists should talk about sexuality with patients with IBD. The first reason mentioned for not addressing the topic was “I would not know what to offer in case of troubles” (31 [45%]), followed by “I don't want to make the patient uncomfortable” (20 [29%]), “I am embarrassed to talk about sexuality with patients” (13 [18.8%]), “I don't have enough time” (6 [9%]), and “This is not my job” (3 [4%]). In case of sexual function impairment, 27 (39%) proposed empathic listening to patients and 15 (22%) a referral to sexology clinic. We reported in a previous study that 52% of patients with IBD expected to discuss sexuality with their specialist.3 Conversely, as observed in our survey, gastroenterologists are reluctant to address this topic with their patients. Indeed, there is still no dedicated questionnaire to evaluate sexual function in IBD. No management guidelines are accessible for physicians in case of sexual impairment. Despite a small size, our sampling represents the opinion of mixed aged gastroenterologists interested in IBD working in secondary and tertiary referral centers. Although nearly all gastroenterologists consider that sexuality is a topic to address with their patients with IBD, only 16% actually do so. Gastroenterologists' training on sexual dysfunction management could help better meet patients' expectations. The authors are grateful to the members of the association Aquitaine Gastro for their participation to this study.