Breaking the Silence: Unveiling Sexual Dysfunction in IBD Patients —Prevalence and Risk Factors in a Moroccan Population

Abstract

Background: Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic condition that significantly impacts patients’ physical and psychological well-being. While sexual dysfunction (SD) in IBD has been widely studied in Western populations, data from North Africa, particularly Morocco, remain scarce. This study aims to assess the prevalence and risk factors associated with SD among Moroccan IBD patients. Methods: We conducted a case-control study that included 100 IBD patients and 100 age- and sex-matched healthy controls. Sexual function was assessed using the Female Sexual Function Index (FSFI) for women and the International Index of Erectile Function (IIEF) for men. Demographic, clinical, and psychological factors were analyzed for their association with SD. Statistical analyses included univariate and multivariate logistic regression models. Results: Among IBD patients, SD was identified in 50% of women and erectile dysfunction (ED) in 15% of men, both significantly higher than in controls (p < 0.05). Active disease, female sex, the presence of stomas, perianal disease, and anxiety-depressive disorders were identified as independent risk factors for SD in IBD patients (p < 0.05). No significant association was found between SD and disease subtype (CD vs. UC), prior surgery, or medication use. Conclusion: Sexual dysfunction is more prevalent in Moroccan IBD patients compared to the general population, particularly among women and those with active disease. The presence of perianal manifestations, stomas, and psychological distress further exacerbates SD. Clinicians should systematically assess and address sexual health in IBD management to enhance patients’ quality of life. Given the sociocultural barriers surrounding sexual health discussions in Morocco, fostering open doctor-patient communication is essential to breaking the taboo and improving patient care.