497: Pain-Related Sexual Dysfunction in Women with Chronic Painful TMD: A Case–Control Study

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary orofacial pain, Psychology, Gender/sex differences

Background and Aims: Chronic painful temporomandibular disorder (TMD) is a prevalent musculoskeletal condition associated with persistent pain, functional impairment, and psychosocial burden. Emerging evidence suggests that chronic pain may negatively influence sexual health; however, this relationship remains insufficiently explored in women with TMD. This study aimed to investigate whether women with chronic painful TMD present worse sexual function and greater psychosocial distress compared with pain-free controls, and to examine the perceived impact of TMD-related pain on sexual functioning.

Methods: This partial analysis derives from an observational case–control study including 87 women (44 with chronic painful TMD diagnosed by DC/TMD; 43 controls). Sexual function was assessed using the Female Sexual Function Index (FSFI), with scores ≤26.55 indicating sexual dysfunction. Psychosocial status was measured with the DASS-21. Perceived interference of TMD pain on sexual function was evaluated using Likert-scale questions. Between-group comparisons were performed using Mann–Whitney tests, while prevalence differences were analyzed with Fisher’s exact test (α=0.05).

Results: Women with painful TMD showed significantly lower FSFI total scores than controls (20.06±10.63 vs 27.99±3.98; p=0.004). Sexual dysfunction prevalence was higher in the TMD group (50.0% vs 25.6%; OR=2.91, 95%CI 1.18–7.19; p=0.027). Strong differences were observed in FSFI pain (3.13±2.11 vs 5.64±1.33; p<0.000001), lubrication (p=0.00075), orgasm (p=0.0042), and satisfaction (p=0.0388). Depression, anxiety, and stress scores were markedly higher in the TMD group (all p<0.001). Participants with TMD reported greater perceived pain-related interference in sexual function (p<0.0001).

Conclusions: Chronic painful TMD was associated with poorer sexual function, higher odds of sexual dysfunction, and greater psychosocial distress. Pain-related interference emerged as a key factor linking TMD to impaired sexual health, reinforcing the multidimensional impact of chronic orofacial pain on women’s quality of life. These findings support a biopsychosocial framework for TMD management and highlight the importance of addressing pain beyond localized symptoms, incorporating broader functional outcomes such as sexual well-being.

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Presenting Author: Victor Hugo Alves Ribeiro-Silva
Submitting Author: Victor Hugo Alves Ribeiro Silva

Senior Author: Victor Hugo Alves Ribeiro-Silva

IASP 2026 Global Year theme of Neuropathic Pain: No

• Maria Amália Dias Pereira Calças - School of Dentistry of Ribeirão Preto, São Paulo University, Brazil.
• Lívia Prado Remédio - School of Dentistry of Ribeirão Preto, São Paulo University (FORP/USP)
• Laiz Franco - Ribeirão Preto School of Nursing, University of São Paulo, Brazil
• Larissa Gregório Candido-do-Prado - School of Dentistry, University of Ribeirão Preto, Brazil
• Giovanna Gallo Martins - School of Dentistry of Ribeirão Preto, São Paulo University, Brazil
• Christie Ramos Andrade Leite-Panissi - School of Philosophy, Sciences and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
• Lúcia Alves da Silva-Lara - Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
• Jardel Francisco Mazzi-Chaves - School of Dentistry of Ribeirão Preto, São Paulo University, Brazil
• Laís Valencise Magri - School of Dentistry of Ribeirão Preto, São Paulo University, Brazil