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Introduction Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system and is widely recognized as a disease primarily affecting women. The relationship between MS and hypogonadism is complex and not fully understood, with recent evidence showing that hypogonadism may have a significant impact on the quality of life and disease progression of patients with MS. Objectives This review aims to provide an overview of the current knowledge regarding the relationship between MS and hypogonadism, including the mechanisms underlying this relationship; the effects of hypogonadism on patients with MS; and the potential benefits and drawbacks of testosterone replacement therapy for patients with MS and hypogonadism. Methods This scientific review analyzed 19 articles that investigated the potential relationship among MS, testosterone levels, and hypogonadism. The articles were published between November 2008 and March 2022 and were identified through a comprehensive search of the PubMed database. The search terms used included “multiple sclerosis,” “testosterone,” “hypogonadism,” and “MS and testosterone levels.” Results Of the 19 articles reviewed, 11 described a positive correlation between low testosterone levels and dysfunction within the hypothalamic-pituitary-gonadal axis in individuals with MS. These findings suggest that low testosterone levels may contribute to dysfunction within the hypothalamus-pituitary-gonadal axis, which plays a crucial role in regulating testosterone production. The results also showed a relationship between sexual dysfunction and low testosterone levels, as well as a positive correlative relationship between these factors. Conclusion The reviewed articles indicate a complex relationship among MS, testosterone levels, and the hypothalamic-pituitary-gonadal axis, with low testosterone levels potentially contributing to dysfunction in this axis and to sexual dysfunction. Further research is needed to better understand the effects of testosterone therapy on MS and sexual dysfunction in patients with MS.
Background Multiple sclerosis (MS) patients frequently experience severe fatigue that can be as disabling as objective neurological deficits. Walking exercise has significant effect in reducing MS-related fatigue. Aim To evaluate the effect of walking exercise on fatigue among patients with MS. Design Nonequivalent control group time series quasi-experimental design was utilized. Research hypotheses H1: the fatigue mean scores of patients with MS who subjected to walking exercise would be less than the fatigue mean scores of a control group after 6 weeks. H2: the fatigue mean scores of patients with MS who subjected to walking exercise would be less than the fatigue mean scores of a control group after 12 weeks. H3: the fatigue mean scores of patients with MS who subjected to 12 weeks of walking exercise would be less than 6 weeks of walking exercise in the study group. Sample A convenient sample of 60 MS patients were recruited along 12 weeks. Tools Four tools were utilized to collect data: (a) Semi-Structured Interview Questionnaire, (b) Fatigue Severity Scale (FSS), (c) The Expanded Disability Status Scale, (d) The Beck Depression Inventory-II. Results supported the stated research hypotheses. As regards, the total mean scores of FSS, there were high statistically significant differences between the study and control groups after 6 and 12 weeks of implementing treadmill walking exercise (35.67 and 49.63 and 29.11 and 50.87, respectively). As well, total mean scores of FSS among the study group after 6 and 12 weeks of implementing treadmill walking exercise was 35.67±10.77 and 29.11±9.93, respectively. Moreover, 76.70% of the study group had no fatigue after 12 weeks of treadmill walking exercise compared with 50% of them after 6 weeks. Conclusion Treadmill walking exercise was effective in reducing fatigue severity level among patients with MS and more than three quarters of the study group had no fatigue after 12 weeks of treadmill walking exercise compared with half of the study group after 6 weeks. Recommendations: this study recommended that patients with MS should practice walking exercise regularly in order to reduce fatigue severity level. Also, further studies should be conducted to compare the effect of different types of walking exercise on MS-related fatigue.
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