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Evaluation of sexual dysfunction in females with neck and upper back myofascial pain syndrome: a cross-sectional study

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Abstract

Myofascial pain syndrome (MPS) is a prevalent chronic musculoskeletal pain disorder that is frequently encountered in clinical practice and can cause sexual dysfunction in women. While there have been studies examining sexual function in various painful rheumatic conditions, particularly fibromyalgia, no studies have been conducted specifically on primary MPS. In this context, we aimed to investigate the frequency of sexual intercourse and the factors associated with it in women diagnosed with MPS. The study was designed as a cross-sectional study at a tertiary rehabilitation center between May 2022 and April 2023. Forty-five consecutive sexually active women (mean age: 38.1 ± 6.8 years) diagnosed with primary MPS were included in the study. They were compared to 45 healthy women of similar ages. The participants were interviewed regarding their weekly frequency of sexual intercourse and the importance of sexual life. Also, the Beck Depression Inventory (BDI) and the Visual Analog Scale (VAS) were assessed. The importance of sexual life score (p = 0.008), BDI (p < 0.001), VAS pain (p < 0.001), and VAS fatigue (p < 0.001) values were found to be lower in the patient group compared to the control group. The frequency of sexual intercourse was lower in the patient group, although this difference did not reach statistical significance (p = 0.083). In patients with a higher BDI score (≥ 17), the number of sexual intercourse was lower (p = 0.044), and the severity of fatigue was higher (p = 0.013). Significant associations were observed in MPS patients between the weekly frequency of sexual intercourse and VAS pain, VAS fatigue, BDI, and the importance of the sexual life score. A positive correlation was observed between the number of weekly sexual intercourses and the importance of the sexual life score (r = 0.577, p < 0.001), and negative correlations were found between BDI (r = − 0.478, p < 0.001), VAS pain (r = − 0.409, p < 0.001), and VAS fatigue (r = − 0.439, p < 0.001). Patients with MPS should be assessed for depressive mood and fatigue, as these factors may contribute to sexual dysfunction. These results may also emphasize the importance of adopting a multidisciplinary approach in the management of MPS patients with concurrent sexual dysfunction. Clinicaltrials.gov identifier: NCT05727566.

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References

  1. Zhang Q, Fu C, Huang L, Xiong F, Peng L, Liang Z, Chen L, He C, Wei Q (2020) Efficacy of extracorporeal shockwave therapy on pain and function in myofascial pain syndrome of the trapezius: a systematic review and meta analysis. Arch Phys Med Rehabil 101(8):1437–1446. https://doi.org/10.1016/j.apmr.2020.02.013

    Article  PubMed  Google Scholar 

  2. Woolf CJ (2011) Central sensitization: implications for the diagnosis and treatment of pain. Pain 152(3 Suppl):S2–S15. https://doi.org/10.1016/j.pain.2010.09.030

    Article  PubMed  Google Scholar 

  3. Urits I, Charipova K, Gress K, Schaaf AL, Gupta S, Kiernan HC, Choi PE, Jung JW, Cornett E, Kaye AD, Viswanath O (2020) Treatment and management of myofascial pain syndrome. Best Pract Res Clin Anaesthesiol 34(3):427–448. https://doi.org/10.1016/j.bpa.2020.08.003

    Article  PubMed  Google Scholar 

  4. Vulfsons S, Minerbi A (2020) The case for comorbid myofascial pain—a qualitative review. Int J Environ Res Public Health 17(14):5188. https://doi.org/10.3390/ijerph17145188

    Article  PubMed  PubMed Central  Google Scholar 

  5. Meyer HP (2002) Myofascial pain syndrome and its suggested role in the pathogenesis and treatment of fibromyalgia syndrome. Curr Pain Headache Rep 6(4):274–283. https://doi.org/10.1007/s11916-002-0048-z

    Article  PubMed  Google Scholar 

  6. Celiker R, Atalay A, Guven Z (2010) Health-related quality of life in patients with myofascial pain syndrome. Curr Pain Headache Rep 14(5):361–366. https://doi.org/10.1007/s11916-010-0141-7

    Article  PubMed  Google Scholar 

  7. Murtagh J (2010) Female sexual function, dysfunction, and pregnancy: implications for practice. J Midwifery Womens Health 55(5):438–446. https://doi.org/10.1016/j.jmwh.2009.12.006

    Article  PubMed  Google Scholar 

  8. Yilmaz H, Gumus H, Yilmaz SD, Akkurt HE, Odabas FO (2017) The evaluation of sexual function in women with stroke. Neurol India 65:271–276

    Article  PubMed  Google Scholar 

  9. Clayton AH, Valladares Juarez EM (2019) Female sexual dysfunction. Med Clin N Am 103(4):681–698. https://doi.org/10.1016/j.mcna.2019.02.008

    Article  PubMed  Google Scholar 

  10. Ferreira Cde C, da Mota LM, Oliveira AC, de Carvalho JF, Lima RA, Simaan CK, Rabelo Fde S, Sarmento JA, de Oliveira RB, Santos Neto LL (2013) Frequency of sexual dysfunction in women with rheumatic diseases. Rev Bras Reumatol 53(1):35–46. https://doi.org/10.1016/s2255-5021(13)70004-x

    Article  PubMed  Google Scholar 

  11. Al-Ezzi M, Tappuni AR, Khan KS (2022) The impact of Sjӧgren’s syndrome on the quality of sexual life of female patients in the UK: a controlled analysis. Rheumatol Int 42(8):1423–1429. https://doi.org/10.1007/s00296-021-04830-6

    Article  PubMed  Google Scholar 

  12. Tristano AG (2009) The impact of rheumatic diseases on sexual function. Rheumatol Int 29(8):853–860. https://doi.org/10.1007/s00296-009-0850-6

    Article  PubMed  Google Scholar 

  13. Douma M, Hatzichristodoulou G, Dimitroulas T (2023) Sexual dysfunction in women with systemic autoimmune rheumatic disorders: a systematic review and meta-analysis. Rheumatology (Oxford) 62(3):1021–1030. https://doi.org/10.1093/rheumatology/keac457

    Article  Google Scholar 

  14. Arslan D, Ünal Çevik I (2022) Interactions between the painful disorders and the autonomic nervous system. Agri 34(3):155–165. https://doi.org/10.14744/agri.2021.43078

  15. Phan VT, Stratton P, Tandon HK, Sinaii N, Aredo JV, Karp BI, Merideth MA, Shah JP (2021) Widespread myofascial dysfunction and sensitisation in women with endometriosis-associated chronic pelvic pain: a cross-sectional study. Eur J Pain 25(4):831–840. https://doi.org/10.1002/ejp.1713

    Article  PubMed  PubMed Central  Google Scholar 

  16. Frederice CP, de Mira TAA, Machado HC, Brito LGO, Juliato CRT (2022) Effect of vaginal stretching and photobiomodulation therapy on sexual function in women with pelvic floor myofascial pain—a randomized clinical trial. J Sex Med 19(1):98–105. https://doi.org/10.1016/j.jsxm.2021.10.008

    Article  PubMed  Google Scholar 

  17. Bourgaize S, Janjua I, Murnaghan K, Mior S, Srbely J, Newton G (2019) Fibromyalgia and myofascial pain syndrome: two sides of the same coin? A scoping review to determine the lexicon of the current diagnostic criteria. Musculoskelet Care 17(1):3–12. https://doi.org/10.1002/msc.1366

    Article  Google Scholar 

  18. Akkurt HE, Yilmaz H, Yilmaz S, Parlak L, Ordahan B, Salli A (2015) Evaluation of sexual dysfunction in females with ankylosing spondylitis. Arch Rheumatol 31(1):41–47. https://doi.org/10.5606/ArchRheumatol.2016.5697

    Article  PubMed  PubMed Central  Google Scholar 

  19. Hisli N (1988) A study on the validity of Beck depression inventory. Psikoloji Dergisi 22:118–126

    Google Scholar 

  20. Johnson C (2005) Measuring pain. Visual Analog Scale versus Numeric Pain Scale: what is the difference? J Chiropractic Med 4(1):43–44. https://doi.org/10.1016/S0899-3467(07)60112-8

  21. Akkurt HE, Yilmaz H, Yilmaz SD, Ordahan B, Şen Z, Gürbüz C, Göksu H (2017) Sexual dysfunction in women with lumbosacral disc disease. J Phys Med Rehabil Sci 20(1):24–30

    Google Scholar 

  22. Anderson RM (2013) Positive sexuality and its impact on overall well-being. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 56(2):208–214. https://doi.org/10.1007/s00103-012-1607-z

    Article  CAS  PubMed  Google Scholar 

  23. Mollaioli D, Sansone A, Ciocca G, Limoncin E, Colonnello E, Di Lorenzo G, Jannini EA (2021) Benefits of sexual activity on psychological, relational, and sexual health during the COVID-19 breakout. J Sex Med 18(1):35–49. https://doi.org/10.1016/j.jsxm.2020.10.008

    Article  CAS  PubMed  Google Scholar 

  24. Rosen RC, Bachmann GA (2008) Sexual well-being, happiness, and satisfaction, in women: the case for a new conceptual paradigm. J Sex Marital Ther 34(4):291–7. https://doi.org/10.1080/00926230802096234(discussion 298–307)

  25. Jannini EA, Fisher WA, Bitzer J, McMahon CG (2009) Is sex just fun? How sexual activity improves health. J Sex Med 6(10):2640–2648. https://doi.org/10.1111/j.1743-6109.2009.01477.x

    Article  PubMed  Google Scholar 

  26. Caruso S, Mauro D, Scalia G, Palermo CI, Rapisarda AMC, Cianci A (2018) Oxytocin plasma levels in orgasmic and anorgasmic women. Gynecol Endocrinol 34(1):69–72. https://doi.org/10.1080/09513590.2017.1336219

    Article  CAS  PubMed  Google Scholar 

  27. Faubion SS, Rullo JE (2015) Sexual dysfunction in women: a practical approach. Am Fam Physician 92(4):281–288

    PubMed  Google Scholar 

  28. Baniotopoulos P, Pyrgidis N, Minopoulou I, Tishukov M, Sokolakis I, Hatzichristodoulou G, Dimitroulas T (2022) Treatment of sexual dysfunction in women with systemic autoimmune rheumatic disorders: a systematic review. Sex Med Rev 10(4):520–528. https://doi.org/10.1016/j.sxmr.2022.08.002

    Article  PubMed  Google Scholar 

  29. Jin Z, Yang C, Xiao C, Wang Z, Zhang S, Ren J (2021) Systemic lupus erythematosus and risk of sexual dysfunction: a systematic review and meta-analysis. Lupus 30(2):238–247. https://doi.org/10.1177/0961203320974081

    Article  PubMed  Google Scholar 

  30. Dorgham D, Haggag HM, Attia DH (2020) Sexual dysfunction in Egyptian females with systemic lupus erythematosus: a cross sectional study. Lupus 29(9):1085–1094. https://doi.org/10.1177/0961203320935518

    Article  CAS  PubMed  Google Scholar 

  31. Uçar İ, Turgay B, Küçükşahin O, Özkan Uçar E, Turgay M (2018) Sexual dysfunction in patients with systemic sclerosis. Turk J Med Sci 48(6):1104–1108. https://doi.org/10.3906/sag-1708-52

    Article  PubMed  Google Scholar 

  32. Štorkánová H, Komarc M, Klein M, Mann H, Pavelka K, Šenolt L, Vencovský J, Tomčík M (2021) Sexual function in patients with idiopathic inflammatory myopathies: a cross-sectional study. Rheumatology (Oxford) 60(11):5060–5072. https://doi.org/10.1093/rheumatology/keab397

    Article  CAS  PubMed  Google Scholar 

  33. Saur SJ, Schlögl A, Schmalen T, Krittian S, Pecher AC, Henes M, Xenitidis T, Henes J (2022) Sexual dysfunction and depression in Behçet’s disease in comparison to healthy controls. Rheumatol Int 42(1):121–126. https://doi.org/10.1007/s00296-021-05000-4

    Article  PubMed  Google Scholar 

  34. Yunus MB (2007) Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Semin Arthritis Rheum 36(6):339–356. https://doi.org/10.1016/j.semarthrit.2006.12.009

    Article  PubMed  Google Scholar 

  35. Katz H, Newton-John TRO, Shires A (2021) Sexual difficulties in the population with musculoskeletal chronic pain: a systematic review. Pain Med 22(9):1982–1992. https://doi.org/10.1093/pm/pnaa451

    Article  PubMed  Google Scholar 

  36. Flegge LG, Barr A, Craner JR (2023) Sexual functioning among adults with chronic pain: prevalence and association with pain-related outcomes. Pain Med 24(2):197–206. https://doi.org/10.1093/pm/pnac11

    Article  PubMed  Google Scholar 

  37. Ricoy-Cano AJ, Cortés-Pérez I, Del Carmen M-C, Del De La Fuenta-Robles YM (2022) Impact of fibromyalgia syndrome on female sexual function: a systematic review with meta-analysis. J Clin Rheumatol 28(2):e574–e582. https://doi.org/10.1097/RHU.0000000000001758

    Article  PubMed  Google Scholar 

  38. Kayhan F, Küçük A, Satan Y, İlgün E, Arslan Ş, İlik F (2016) Sexual dysfunction, mood, anxiety, and personality disorders in female patients with fibromyalgia. Neuropsychiatr Dis Treat 12:349–355. https://doi.org/10.2147/NDT.S99160

    Article  PubMed  PubMed Central  Google Scholar 

  39. Yilmaz H, Yilmaz SD, Polat HA, Salli A, Erkin G, Ugurlu H (2012) The effects of fibromyalgia syndrome on female sexuality: a controlled study. J Sex Med 9(3):779–785. https://doi.org/10.1111/j.1743-6109.2011.02619.x

    Article  PubMed  Google Scholar 

  40. Cerezo-Téllez E, Torres-Lacomba M, Mayoral-Del Moral O, Sánchez-Sánchez B, Dommerholt J, Gutiérrez-Ortega C (2016) Prevalence of myofascial pain syndrome in chronic non-specific neck pain: a population-based cross-sectional descriptive study. Pain Med 17(12):2369–2377. https://doi.org/10.1093/pm/pnw114

    Article  PubMed  Google Scholar 

  41. Ye AL, Adams W, Westbay LC, Fitzgerald CM (2020) Evaluating disability-related quality of life in women with chronic pelvic pain. Female Pelvic Med Reconstr Surg 26(8):508–513. https://doi.org/10.1097/SPV.0000000000000771

    Article  PubMed  Google Scholar 

  42. Tim S, Mazur-Bialy AI (2021) The most common functional disorders and factors affecting female pelvic floor. Life (Basel) 11(12):1397. https://doi.org/10.3390/life11121397

    Article  PubMed  Google Scholar 

  43. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D'Agostino R Jr (200) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26(2):191–208. https://doi.org/10.1080/009262300278597

  44. Domoney C (2009) Sexual function in women: what is normal? Int Urogynecol J Pelvic Floor Dysfunct 20(Suppl 1):S9–S17. https://doi.org/10.1007/s00192-009-0841-x

    Article  PubMed  Google Scholar 

  45. Gündüz A, Topçuoğlu V, Usta Gündüz EB, Ergun T, Gençosmanoğlu DS, Sungur MZ (2020) Significant effects of body image on sexual functions and satisfaction in psoriasis patients. J Sex Marital Ther 46(2):160–169. https://doi.org/10.1080/0092623X.2019.1654582

    Article  PubMed  Google Scholar 

  46. Lamba A, Mohajir N, Rahman S (2023) A review of the psychosocial factors that contribute to sexuality, female sexual dysfunction, and sexual pain among Muslim women. Sex Med Rev. 11:qead019. https://doi.org/10.1093/sxmrev/qead019

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Konya Beyhekim Training and Research Hospital, University of Health Sciences, Konya, Turkey

    Ramazan Yılmaz, Savaş Karpuz, Emine Akdere & Halim Yılmaz

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Contributions

RY, SK, EA, and HY developed the concept, research aims, and methodology for the present study. RY, EA, and SK recruited participants and conducted data collection. RY prepared and wrote the first draft of this manuscript, with reviews and revisions undertaken by all authors. According to the ICMJE authorship criteria, all authors have fulfilled the requirements of providing final approval for the version to be published and agree to be accountable for all aspects of the work, including the investigation and resolution of any questions regarding the accuracy or integrity of the manuscript.

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Correspondence to Ramazan Yılmaz.

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Ethical approval

The present study protocol was approved by the Ethics Committee of Hamidiye Scientific Research Ethics Committee (date: 06.04.2022, and approval number: 9/22). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the principles of the Declaration of Helsinki. The study was registered on ClinicalTrials.gov (NCT number: NCT05727566).

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Yılmaz, R., Karpuz, S., Akdere, E. et al. Evaluation of sexual dysfunction in females with neck and upper back myofascial pain syndrome: a cross-sectional study. Rheumatol Int 43, 1723–1732 (2023). https://doi.org/10.1007/s00296-023-05359-6

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