Evaluation of the association between sexual dysfunction and demyelinating plaque location and number in female multiple sclerosis patients

Abstract

Purpose To investigate the frequency of sexual dysfunction (SD) in female multiple sclerosis (MS) patients and to explore its association with the location and number of demyelinating lesions. Material and Methods We evaluated 42 female patients and 41 healthy subjects. All patients underwent neurological examination and 1.5 T brain and full spinal MRI. All subjects completed the female sexual function index (FSFI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Short-Form 36 Quality of Life Scale (SF-36). All participants were also evaluated for serum thyroid stimulating hormone (TSH), T4, estradiol, and total testosterone. Results No statistically significant differences between the MS and control groups were found for age, body mass index (BMI), serum TSH, T4, E2, and total testosterone level. MS patients had a statistically significantly lower FSFI and SF-36 scores and higher BDI and BAI scores compared with healthy subjects. The location and number of demyelinating lesions were not associated with SD. Conclusion In our cohort, this difference in SD appears unrelated to the location and number of demyelinating lesions. These findings highlight the importance of the assessment and treatment of psychiatric comorbidities, such as depression and anxiety, in MS patients reporting SD.

Systematic review of the prevalence, symptomatology and management options of sexual dysfunction in women with multiple sclerosis

“…Different patient characteristics were found to be associated with SD including advancing age, lower educational level, and poor QoL . MS‐related parameters found to be associated with SD were longer disease duration, progressive MS, greater neurological disability, worse physical functions, fatigue, urinary problem, and poor cognitive function .…”

“…Results of case-control studies (n = 14): The prevalence of SD in women with MS was reported to be 34.9% to 95% (n = 8 studies). In these studies, SD rates were reported to be higher in PwMS compared to healthy control [45][46][47][48][49][50][51][52][53] and the difference was found to be statistically significant in eight studies [45][46][47][48][49][50][51]53 (Table S1). No significant differences in prevalence were seen compared with other chronic neurological disorders (migraine).…”

Assessment of sexual dysfunction in patients with inflammatory bowel disease

“…The presented tool is characterised by high credibility and is often used in research on women’s sexuality around the world. Very diverse groups of women take part in these studies, for example patients with multiple sclerosis [22], hyperthyroidism [23], overweight [24], suffering from neoplastic diseases [25], or endometriosis [26]. In addition, the questionnaire is adaptable enough for use among women of varying stages of sexual development, from the pre- to post-menopausal periods [27].…”

Psychobehavioral Treatment Options for Sexual Dysfunction in Multiple Sclerosis

“…9 Primary sexual dysfunction in MS is caused by MS-related neurologic changes in the central nervous system, such as damage in the brain, in the spinal cord areas, and in the peripheral neurons engaged in sexual response. [10][11][12] Female primary sexual dysfunction in MS includes reduced libido (up to 85%), difficulties in achieving orgasm (up to 73%), reduced lubrication (up to 47%), changes in vaginal sensation (up to 30%), and anorgasmia (29%). 7 Primary sexual dysfunction in men with MS mainly refers to reduced libido (up to 70%), incomplete or total loss of erectile functions (up to 67%), and inability to ejaculate or premature ejaculation (up to 52%).…”