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Reprod. Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypermobile Ehlers\u2013Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSDs) are heritable connective tissue disorders characterized by widespread fragile soft connective tissue affecting the skin, ligaments, joints, vasculature, and internal organs. Although hEDS and HSD are autosomal-dominant conditions and would be expected to display a 1:1 sex ratio, studies report higher prevalence in women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The purpose of this exploratory study was to determine whether self-reported sexual problems differed between females and males diagnosed with hEDS or HSD compared with controls with chronic pain but no hypermobility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this exploratory retrospective study, we examined 1,407 patients diagnosed with hEDS or HSD according to the 2017 diagnostic criteria for eight indicators of sexual problems based on a validated screening tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients in each diagnosis primarily self-reported as White, non-Hispanic females (90%). Of the 1,407 patients who attended the EDS Clinic, 976 (69%) were diagnosed with HSD, 240 (17%) with hEDS, and 191 (14%) were chronic pain controls with neither diagnosis. For HSD, 937 (96%) were females vs. 39 (4%) males (24:1 females to males), while for hEDS, 210 (88%) were females vs. 30 (13%) males (7:1 females to males), and controls were 165 (86%) females vs. 26 (14%) males (6:1 females to males). Females with hEDS reported significantly higher rates of sexual issues than chronic pain controls, including sexual problems (69%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018), problems with sexual interest (41%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023), sexual pain (45%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), and orgasm difficulty (34%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022) compared with males with hEDS or males or females with HSD. In contrast, males diagnosed with hEDS did not report any sexual problems over controls, and males and females diagnosed with HSD reported only one issue\u2014more problems with sexual interest\u2014compared with controls (females\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019, males\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). However, the small number of males in this study limits conclusions that can be drawn for them.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study is unique because we examine sex differences in sexual problems in patients with hEDS and HSD. Our findings indicate a higher percentage of sexual problems in females with hEDS than chronic pain controls without hypermobility, but this was not observed for females with HSD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frph.2026.1753684","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T05:42:45Z","timestamp":1775022165000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Females with hypermobile Ehlers\u2013Danlos syndrome self-report more sexual problems than chronic pain controls without hypermobility, males, or patients with hypermobile spectrum disorders"],"prefix":"10.3389","volume":"8","author":[{"given":"Cynthia E.","family":"Neville","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Mayo Clinic","place":["Jacksonville, FL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frances C.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic","place":["Jacksonville, FL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"DeLisa","family":"Fairweather","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic","place":["Jacksonville, FL, United States"]},{"name":"Department of General Internal Medicine, Mayo Clinic","place":["Jacksonville, FL, United States"]},{"name":"Center for Clinical and Translational Science, Mayo Clinic","place":["Rochester, MN, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa K.","family":"Caywood","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Mayo Clinic","place":["Jacksonville, FL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Gegoutchadze","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Florida","place":["Gainesville, FL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lincoln E.","family":"Rozen","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic","place":["Jacksonville, FL, United States"]},{"name":"Division of Cardiovascular Medicine, University of Florida","place":["Gainesville, FL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick A.","family":"Farahani","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Florida","place":["Gainesville, FL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chrisandra L.","family":"Shufelt","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Mayo Clinic","place":["Jacksonville, FL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dacre R. 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