Sex, reproduction, and gynecological disease in young adults with a history of juvenile chronic arthritis

Objective. To study the effect of chronic disease of childhood on aspects o f reproduction in young adults with a history of juvenile chronic arthritis (JCA). Methods. Demographic data, clinical features of JCA, previous medical treat ment, reproductive events, contraception, wish for children, sexuality, and gynecological disease were evaluated by means of a questionnaire in 126 wo men and 35 men with JCA and their age matched healthy counterparts. Results. Median age of patients and controls was 24 years. Median age at me narche was 13 years in female patients and controls. Female patients who sh ared characteristics of marital status with their healthy counterparts show ed a similar attitude to sexual activity, contraception, wish for children, age at first child, and duration of lactation. Fertility was not impaired in JCA, but fecundity was significantly reduced. Also, pregnancy outcome wa s less successful in women with JCA, shown by a significantly increased rat e of miscarriage. When analyzing the occurrence of gynecological disease, a higher proportion of patients had metrorrhagia, pelvic inflammatory diseas e, and surgery for ovarian cysts. Males with JCA had greater difficulties t han both healthy males and female patients in establishing a permanent rela tionship to the opposite sex. Conclusion. Our study shows that a history of JCA in young men and women ca n influence several aspects of reproductive behavior and health. Health car e providers counseling adolescents with JCA need to be aware of these probl ems.