Association between sexual dysfunction and symptom burden in women with Chronic Obstructive Pulmonary Disease

Objectives To investigate sexual dysfunction as a clinically relevant but under-recognized manifestation of disease burden in women with COPD and to identify its clinical and psychological determinants. Study design In this cross-sectional study, 100 consecutive women with stable COPD (mean age 57 ± 7 years) attending an outpatient chest clinic were enrolled. Main outcome measures Participants underwent pulmonary function testing and completed the COPD Assessment Test (CAT), Modified Medical Research Council (mMRC) scale, Beck Depression Inventory, Short Form-36 (SF-36), Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-FS), and Female Sexual Function Index (FSFI). Results Sexual dysfunction (FSFI ≤26.55) was more prevalent in patients with greater disease burden, particularly those in GOLD stage E, and was associated with significantly higher fatigue and depressive symptoms. FSFI scores showed a positive correlation with FACIT-FS and quality-of-life domains, and a negative correlation with depression scores (all p < 0.05). In multivariable analysis, fatigue was positively associated with FSFI scores, whereas depression and body mass index were negatively associated. Patients with more severe disease (GOLD E), comorbidities, and dyspnea during intercourse had lower FSFI scores, while those receiving triple therapy demonstrated higher scores. Conclusions Sexual dysfunction was associated with greater symptom burden in women with COPD and was closely related to fatigue and depression. Assessment of sexual function may contribute to a more comprehensive evaluation of disease burden in clinical practice.