Abstract
Study design:
Case–control study.
Objectives:
(i) To describe the prevalence of sexual dysfunction in chronic low back pain (CLBP) patients, (ii) to compare the range of sexual function outcomes between patients with CLBP and healthy controls and (iii) to investigate which factors are associated with sexual function within the cohort of individuals with CLBP.
Setting:
Low back pain (LBP) clinic of Qazvin University of Medical Sciences, Qazvin, Iran.
Methods:
A total of 702 patients with CLBP and 888 healthy controls participated in the study. The Female Sexual Function Index (FSFI), International Index of Erectile Function (IIEF) and Premature Ejaculation Diagnostic Tool (PEDT) were used to evaluate sexual function. In addition, quality of life, anxiety, functional status and pain intensity were assessed in patients. Univariate and multiple linear regression analyses were performed for the identification of factors associated with sexual function.
Results:
The prevalence of sexual problems in female patients with CLBP was 71.1% (n=177) while the corresponding figure for healthy women was 36.8% (n=161). Erectile dysfunction was present in 59.5% of male patients and in 24.5% of healthy males. Higher sexual function in both male and female patients with CLBP were being younger, lower duration of back pain, lower BMI, higher education level, being unemployed, physically active shorter sick leave, lower level of pain intensity, lower disability, higher family income, lower levels of depressive and anxiety symptoms, and higher psychical functioning and mental functioning.
Conclusions:
CLBP patients report considerably higher prevalences of sexual problems compared with healthy controls. Sex therapy and sexual management should be added to routine care and treatment of patients with CLBP.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Picavet HS, Schouten JS . Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC(3)-study. Pain 2003; 102: 167–178.
Huijnen IP, Kindermans HP, Seelen HA, Peters ML, Smeets RJ, Serroyen J et al. Effects of self-discrepancies on activity-related behaviour: explaining disability and quality of life in patients with chronic low back pain. Pain 2011; 152: 2165–2172.
Jordan KP, Kadam UT, Hayward R, Porcheret M, Young C, Croft P . Annual consultation prevalence of regional musculoskeletal problems in primary care: an observational study. BMC Musculoskelet Disord 2010; 11: 144–163.
Croft PR, Macfarlane GJ, Papageorgiou AC, Thomas E, Silman AJ . Outcome of low back pain in general practice: a prospective study. BMJ 1998; 316: 1356–1359.
National Institute of Neurological Disorders and Stroke. Low Back Pain Fact Sheet. National Institutes of Health Publication number 03-5161. Washington DC: National Institute of Neurological Disorders and Stroke. 2003.
Mousavi SJ, Akbari ME, Mehdian H, Mobini B, Montazeri A, Akbarnia B et al. Low back pain in Iran: a growing need to adapt and implement evidence-based practice in developing countries. Spine 2011; 36: E638–E646.
Stock SR, Cole DC, Tugwell P, Streiner D . Review of applicability of existing functional status measures to the study of workers with musculoskeletal disorders of the neck and upper limb. Am J Ind Med 1996; 29: 679–688.
Berg S, Fritzell P, Tropp H . Sex life and sexual function in men and women before and after total disc replacement compared with posterior lumbar fusion. Spine J 2009; 9: 987–994.
Bahouq H, Fadoua A, Hanan R, Ihsane H, Najia HH . Profile of sexuality in Moroccan chronic low back pain patients. BMC Musculoskelet Disord 2013; 14: 63–68.
Haefeli M, Elfering A . Pain assessment. Eur Spine J 2006; 15 (Suppl 1): S17–S24.
Mousavi SJ, Parnianpour M, Mehdian H, Montazeri A, Mobini B . The Oswestry Disability Index, the Roland-Morris Disability Questionnaire, and the Quebec Back Pain Disability Scale: translation and validation studies of the Iranian versions. Spine 2006; 31: E454–E459.
Zigmond AS, Snaith RP . The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67: 361–370.
Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B . The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Qual Life Res 2005; 14: 875–882.
Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R et al. The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000; 26: 191–208.
Fakhri A, Pakpour AH, Burri A, Morshedi H, Zeidi IM . The Female Sexual Function Index: translation and validation of an Iranian version. J Sex Med 2012; 9: 514–523.
Pakpour AH, Zeidi IM, Yekaninejad MS, Burri A . Validation of a translated and culturally adapted Iranian version of the International Index of Erectile Function (IIEF-15). J Sex Marital Ther, (e-pub ahead of print 10 October 2013; doi:10.1080/0092623x.2013.788110).
Pakpour AH, Yekaninejad MS, Nikoobakht MR, Burri A, Fridlund B . Psychometric Properties of the Iranian version of the Premature Ejaculation Diagnostic Tool (PEDT). Sex Med, (in press).
Ambler N, Williams AC, Hill P, Gunary R, Cratchley G . Sexual difficulties of chronic pain patients. Clin J Pain 2001; 17: 138–145.
Duquesnoy B, Allaert FA, Verdoncq B . Psychosocial and occupational impact of chronic low back pain. Rev Rhum Engl Ed 1998; 65: 33–40.
Leiblum RS . Reconsidering gender differences in sexual desire: An update. Sex Relation Ther 2002; 17: 57–68.
Abbasi M, Dehghani M, Keefe FJ, Jafari H, Behtash H, Shams J . Spouse-assisted training in pain coping skills and the outcome of multidisciplinary pain management for chronic low back pain treatment: a 1-year randomized controlled trial. Eur J Pain 2012; 16: 1033–1043.
Campbell P, Jordan KP, Dunn KM . The role of relationship quality and perceived partner responses with pain and disability in those with back pain. Pain Med 2012; 13: 204–214.
Metza ME, McCarthy BW . The ‘Good-Enough Sex’ model for couple sexual satisfaction. Sex Relation Ther 2007; 22: 351–362.
Acknowledgements
We thank Qazvin University of Medical Sciences for support to conduct the study. We also thank all the patients and nurses as well as Mrs Mahdieh Pakpour who kindly helped us to collect data.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Nikoobakht, M., Fraidouni, N., Yaghoubidoust, M. et al. Sexual function and associated factors in Iranian patients with chronic low back pain. Spinal Cord 52, 307–312 (2014). https://doi.org/10.1038/sc.2013.151
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sc.2013.151
Keywords
This article is cited by
-
Prevalence of Sexual Disability and its Relationship with Pain Intensity, Quality of life and Psychological Distress Among Individuals with Chronic Low Back Pain in Nigeria: A Cross-Sectional Study
Sexuality and Disability (2024)
-
Posterior lumbar fusion surgery doesn’t change sexual activities in patients with lumbar degenerative disease: an observational study
BMC Musculoskeletal Disorders (2023)
-
The correlation between sexual dysfunction and intimate partner violence in young women during pregnancy
BMC International Health and Human Rights (2020)
-
Association between low back pain and various everyday performances
Wiener klinische Wochenschrift (2019)
-
Sexual Functioning and Selected Clinical and Psychosocial Factors Among Individuals with Chronic Non-specific Low Back Pain in Ibadan, Nigeria
Sexuality and Disability (2018)