Sexual difficulties of chronic pain patients

Objective: Description of the specific physical and psychological problems associated with sexual activity in patients with chronic pain. Design: Self-completion questionnaire on extent and nature of sexual diffic ulties related to pain: data on psychological and physical function in resp ondents: personal and medical data for respondents and nonrespondents. Patients: Three hundred twenty-seven patients with chronic pain in inpatien t and outpatient pain programs: 237 (72%) completed the questionnaire. Measures: Extent of general and specific sexual problems: anxiety and depre ssion (Hospital Anxiety and Depression Scale [HAD]); pain self-efficacy; pa in-related disability (Sickness Impact Profile); drug use. Results: Respondents were younger and had less depressed mood than nonrespo ndents. but there were no other major differences. Seventy-three percent of respondents had pain-related difficulty with sexual activity; most had sev eral. in various combinations of problems with arousal, position, exacerbat ing pain, low confidence, performance worries. and relationship problems. A ll except position difficulties were associated with less frequent sexual a ctivity. There were few differences between men and women, and only weak re lations emerged between specific problems and mood and disability. Conclusions: There is a high prevalence of sexual difficulties in patients with chronic pain attending treatment, nearly double that of a general UK s urvey. These difficulties are not simply related to mood or disability. The range of problems and patients' expressed preferences for help suggest tha t multidisciplinary intervention is required.