Abstract
INTRODUCTION: Sexual life is important for many people and may be limited by breathlessness. We evaluated associations between breathlessness and individuals' perceived satisfaction with sexual lives and explored mediating factors in this relationship. METHODS: A cross-sectional, online, population-based survey of Australian adults with key demographics (age, sex, rurality, state/territory) reflected the 2016 national census. Assessments included: demographics, breathlessness (modified Medical Research Council (mMRC) scale); satisfaction with overall sexual life; whether breathlessness had affected overall sexual life and physical, social and emotional functioning. Binomial and ordinal logistic regression evaluated associations; a structural equation model evaluated direct, indirect and total associations. RESULTS: Of 10 033 respondents (52% women; mean age 45.4 (SD 18.6)), 4245/10 033 (42%) reported mMRC ≥1, 1214/10 033 (12%) reported being very dissatisfied with their overall sexual life and 943/10 033 (9%) reported that breathlessness had impacted their overall sexual life. Compared with mMRC 0, there was an unadjusted association between mMRC 1 and satisfaction with overall sexual life which remained after adjusting for age, sex and body mass index (adjusted OR (aOR): 1.50; 95% CI 1.29 to 1.74).Breathlessness severity was associated with worse unadjusted and adjusted impact on overall sexual life: mMRC 0 versus mMRC 1 (aOR: 1.84; 95% CI 1.36 to 2.47). The associations increased stepwise for each higher mMRC level. There may be moderation of the effect of breathlessness on satisfaction with sexual life through emotional functioning. CONCLUSIONS: Increasing breathlessness severity increases the likelihood of a person's overall sexual life being impacted negatively, potentially mediated partly through emotional functioning.