1. Determine if self-report sexual function impairments differ between females diagnosed with HSD/ hEDS compared to female controls confirmed to not have either diagnosis 2. Determine if self-report sexual function impairments differ between females with confirmed diagnosis of HSD and hEDS.
Patients seeking diagnosis at the Ehlers Danlos Clinic at our institution were sent a self-reported intake questionnaire via Research Electronic Data Capture (REDCap) that included sexual health questionnaires. Patients were diagnosed with either hEDS, HSD, or no hypermobility (controls). Data was extracted, cleaned, and prepared utilizing Excel. Statistical analysis was performed in GraphPad Prism utilizing Mann-Whitney test for continuous data and Fisher’s Exact test for binary or categorical data. The following comparisons were made assessing potential sexual health problems: Control vs hEDS or HSD, Control vs hEDS alone, Control vs HSD alone and hEDS vs HSD. Statistical significance for differences between groups was set at p.05.
A total of 1,312 females completed the questionnaire between February 2020 and May 2024. The control group consisted of 165 females, 937 were diagnosed with HSD, and 210 were diagnosed with hEDS. “Sexual problems” were reported by 64.2% of females with HSD or hEDS. Compared to controls, females with either HSD/hEDS were significantly more likely to report “sexual pain,” “sexual anxiety,” and decreased “sexual interest.” Sexual pain was reported by 39.3% of females with HSD/hEDS. Females with HSD were more likely to report decreased “sexual interest” compared with controls. Females with hEDS were more likely to also report “sexual problems” and “orgasm difficulty” compared to controls. There were no differences in self-reported sexual function impairments between those with HSD compared to those with hEDS.
Females with HSD and hEDS report a significantly greater rate of sexual pain and sexual function impairments than controls. While there were no significant differences between females with HSD and hEDS, females with hEDS experience greater orgasm difficulty and sexual problems compared to controls.
Whether a female has a confirmed diagnosis of HSD or hEDS, sexual function impairments and sexual pain are prevalent and associated with negative cognitive, behavioral, and emotional consequences. Sexual pain in females with HSD/hEDS is associated with musculoskeletal factors including pelvic girdle pain and pelvic floor myofascial pain (Ali 2020). Physical therapists play a key role to play in addressing sexual function and sexual pain issues in females with HSD and hEDS.
female sexual function
pelvic pain
