Primary Sjögren’s Syndrome (pSS) is an autoimmune disorder in which certain cells malfunction and overpower the glands that provide lubrication to a variety of areas. Those with pSS may experience extreme dry eye and mouth, as well as an increased risk of getting infections of any kind.

pSS primarily affects women, usually beginning in their 40s-60s (around the menopause). With symptoms like vulvar and vaginal dryness, dyspareunia (pain with sex), vaginal itching, genital pain, and painful urination, pSS may exacerbate similar menopausal symptoms.

Because of the similar timing of menopause and typical pSS onset, researchers seek to confirm whether there is a higher prevalence of female sexual dysfunction (FSD) in women with pSS. Combining the results of 16 studies on the subject, a total number of 969 women with pSS and 2315 healthy women were compared to determine a potential risk for FSD, as well as any specific sexual function that may be affected.

Women With pSS Experience Sexual Dysfunction, and Then Some

The results revealed that women with pSS were 4.5 times more likely to report sexual dysfunction than the healthy women. This was confirmed by the female sexual function index (FSFI), which asks about women’s experience with sexual function, as well as the aspects of arousal, lubrication, orgasm, satisfaction, and desire.

The lower FSFI scores (indicating FSD) may be because of vaginal dryness and dyspareunia, which are already associated with pSS. This illness is likely affecting women both directly and indirectly, with desire, arousal, and satisfaction suffering as a result of the effects of low lubrication and pain from dyspareunia. Someone who experiences pain every time they have sex is often less likely to seek it out or enjoy it regularly.

Additionally, the effects of a chronic illness tend to play a role in someone’s willingness to be sexually active. Many women with pSS may have other chronic illnesses and may be going through menopause – which tends to make the genital and urinary symptoms of pSS worse or more consistent. This high level of stress, anxiety, and a higher prevalence of depression amongst those with pSS also tend to influence desire, arousal, and satisfaction. Finally, pelvic floor dysfunction as a result of menopause or nerve damage from pSS may make sex more painful or difficult for this population of women.

Key Points

• Primary Sjögren’s Syndrome increases the risk of female sexual dysfunction by about 5-fold.
• FSD in women with pSS is primarily due to dryness as a result of immune cells malfunctioning and attacking mucus membranes in the vagina.
• Resulting effects on sexual function may be exacerbated by the menopausal age group that typically presents pSS symptoms.
• If you believe you have pSS, or are experiencing sexual distress from pSS, it may be beneficial to speak with a sexual health professional.

Resources

• D’Andrea, S., Vinci, A., Navarini, L., Sansone, A., Marino, A., Bardhi, D., Bruno, A., Rosiello, F., Lombardo, C., Agostini, E., Ingravalle, F., Gentili, S., Maurici, M., Berardicurti, A., Jannini, E. A., Giacomelli, R., & Berardicurti, O. (2025). Evaluation of sexual dysfunction among women with primary Sjögren’s syndrome using a female sexual function index: A systematic review and meta-analysis. The Journal of Sexual Medicine, 22(8), 1399–1408. https://doi.org/10.1093/jsxmed/qdaf110