In primary Sjogren Syndrome (pSS), health-related quality of life (HRQoL) and sexual health are impaired and correlated. HRQoL in pSS is similarly altered in respect to patients with not Sjogren Sicca Syndrome (nS-SS) (presenting ocular and oral dryness, with negative autoantibodies and lip biopsy). As expected, in pSS and ns-SS, HRQoL is related to involvement of salivary and lachrymal glands, mainly with dryness. In pSS and nS-SS, HRQoL is associated with anxiety and fatigue and, only in pSS, with depression. Pain, muscle skeletal concerns, and lung involvement are other determinants of HRQoL in pSS. In women with pSS and nS-SS, sex health and ability, similarly altered, are affected by gynecological concerns more than by muscle-skeletal symptoms and, importantly, are related to impaired HRQoL.