GYNECOLOGIC MANIFESTATIONS OF SJOGRENS-SYNDROME

OBJECTIVE: Sjogren's syndrome is a chronic, inflammatory autoimmune di sease in which the salivary and lacrimal glands are Progressively dest royed by lymphocytes and plasma cells. Because women are affected 10 t imes more often than men, we studied gynecologic manifestations of Sjo gren's syndrome. STUDY DESIGN: One thousand questionnaires were sent t o women with Sjogren's syndrome in New York, New Jersey, Connecticut, and Pennsylvania. Five hundred thirty-nine women responded. RESULTS: W omen with Sjogren's syndrome reported significant vaginal dryness. The re was no relationship of Sjogren's syndrome to either the incidence o f infertility or miscarriage, although the 4% incidence of congenital anomalies in offspring was relatively high. Of the congenital anomalie s, nine of 19 (47%) were cardiac. A long menstrual cycle (> 35 days) w as associated with infertility and neuropathy. CONCLUSIONS: The vagina l dryness in women with Sjogren's syndrome is not surprising, because the nasal and esophageal mucosae are also dry in this disorder. The re lationship of infertility to a long menstrual cycle may simply indicat e the presence of ovulatory dysfunction or inadequate luteal phase unr elated to Sjogren's syndrome. The relationship of neuropathy to a long menstrual cycle may be related to repeated, prolonged estrogen or pro gesterone exposure during the long cycles or to involvement of hypotha lamic-pituitary-ovarian function.