Ottem DP et al. (2007) Interstitial cystitis and female sexual dysfunction. Urology 69: 608–610

Pelvic pain or pain during sexual intercourse is a clinical feature of interstitial cystitis (IC), but is not characteristic and might be misdiagnosed as endometriosis, vulvodynia, or vulvar vestibulitis. Ottem and colleagues, therefore, used the Female Sexual Function Index (FSFI) to assess whether IC is associated with sexual dysfunction.

The authors enrolled 75 consecutive patients with newly diagnosed IC and 22 asymptomatic controls. Self-reported dyspareunia, mean daily voided volume (not including the first morning volume), and Pelvic Pain and Urgency/Frequency score were compared between these two groups and between women with IC with or without dyspareunia. All participants had been sexually active within the past month.

A significantly greater proportion of patients with IC than controls reported dyspareunia (54 vs 1) and had higher Pelvic Pain and Urgency/Frequency scores (18 vs 3) and lower voided volumes (169 ml vs 294 ml; all P <0.0001). Adjusted FSFI scores were lower among patients with IC than among controls (20.2 ± 9.6 vs 29.9 ± 6.3; P <0.0001). Overall, 51 patients with IC had abnormally low FSFI scores (<26.55) compared with 3 controls (P <0.001). Patients with IC scored all FSFI parameters (desire, arousal, lubrication, orgasm, satisfaction, pain) lower than controls. All parameters, except pain, were similar in patients with IC who did not report dyspareunia and in those with IC who did.

The authors conclude that all domains of female sexual dysfunction affect patients with IC. They suggest that taking a voiding history might help to differentiate these patients from those with dyspareunia from other causes.