Prevalence and associated factors of sexual dysfunction in female patients with immune thrombocytopenia: a longitudinal follow-up study

Sexual health is an important part of life; however, it has long been overlooked in patients with immune thrombocytopenia (ITP), primarily due to concerns regarding low platelet counts and bleeding risk. This study aimed to assess the prevalence of sexual dysfunction in female patients with ITP and to analyze the factors contributing to this condition. This was a single-center longitudinal follow-up study that enrolled female patients aged 18 to 65 years with newly diagnosed ITP between January 2021 and December 2023. Sexual function was assessed using the Female Sexual Function Index (FSFI) at baseline (within 48 h of admission) and at the 6- and 12-month follow-up. Demographic and clinical data of patients were additionally collected, and their fatigue burden, anxiety levels, and quality of life were assessed. Logistic regression analysis was employed to identify risk factors. A total of 146 patients were enrolled in this study. At baseline, sexual dysfunction was identified in 36.30% of female patients with ITP. At 6-month and 12-month follow-ups, the proportion of patients with sexual dysfunction was 41.84% and 54.07%, respectively. Compared with patients without corticosteroid dependence (49.54%), those on two or fewer medications (44.83%), and those with only isolated cutaneous bleeding (51.90%), the prevalence of sexual dysfunction was significantly higher in patients with corticosteroid dependence (73.08%, P = 0.047), those receiving more than two medications (70.83%, P = 0.004), and those with wet or internal bleeding (70%, P = 0.007). Spearman correlation analysis revealed that as the follow-up duration increased, the correlation between fatigue and the FSFI score weakened, whereas the correlations between anxiety, quality of life, and the FSFI score strengthened. A platelet count of <30 × 109/L (OR = 4.996; P = 0.039), wet or internal bleeding (OR = 3.744; P = 0.016), and the use of more than two medications (OR = 2.861; P = 0.031) were independent risk factors for sexual dysfunction in patients with ITP at the 12-month follow-up. ITP can adversely affect female patients’ sexual function. Based on the results of logistic regression analysis, rational and individualized intervention plans should be developed to improve sexual function in female patients with ITP.