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Rose shared that it is crucial to understand that the largest factor leading to sexual dysfunction is not physical.

In one study, four percent of SLE patients experienced problems with sexual functioning.

Professionals are not sure if it is their right to ask and are often ambivalent: "Am I supposed to be talking about this? " Also, a lot of physicians are not trained in this area, so they feel they can't address it. "Yes, sex as a topic is still taboo and uncomfortable for many of us," Rose noted.

"That may come from cultural influences, how we were brought up, the society we live in, and how our parents display affection." Fear, she suggested, is another factor.

Sexual functioning is not normally a part of a routine physical exam, so it is rarely brought up during the exam. Tristano interviewed about 10 rheumatologists who had large rheumatology practices, and only 12 percent of these surveyed said they assessed for sexual functioning.(1) "That is a very, very low percentage of rheumatologists with large practices who saw over 500 patients," said Rose. Therefore, it clearly shows that we're not talking about it." Why are Professionals Silent and Why are You and I Silent?

Intimacy involves you as whole person -- how you perceive yourself and how you share yourself with others.

Sexuality is often overlooked as a topic of discussion in the healthcare system. " Rose explained how infrequently sexuality or sexual functioning is addressed with patients.

Sixty percent of those RA patients were dissatisfied with the quality of their sex life, and sexual dysfunction was experienced equally by both male and female patients.(2) We can see over time that patients with rheumatic illnesses such as RA or SLE may lose interest in participating in sexual activities and satisfaction.

Also, men and women with SLE don't discriminate in terms of how they experience sexual dysfunction at similar levels.