Sexual Dysfunction in People with Multiple Sclerosis: The Role of Disease Severity, Illness Perception, and Depression

Abstract

Despite being a common issue in people with multiple sclerosis (pwMS), sexual dysfunction is still underinvestigated. This work aims to assess the potential determinants of sexual dysfunction in pwMS by considering its relationship with disease severity (in terms of global disability), illness perception, and depressive symptoms. In this multicenter study, 1010 pwMS responded to an online survey. A serial mediation model considering negative illness perception and depressive symptoms as mediators of the relationship between disease severity and sexual dysfunction was conducted using the SPSS PROCESS Macro with bias-corrected bootstrapping (5000 samples). Disease severity exerts an indirect effect on sexual dysfunction via illness perception, both independently and through depressive symptoms. However, the results indicated that illness perception plays a more crucial role in sexual dysfunction in pwMS with mild disability than in pwMS with moderate-severe disability. This study suggests that higher disability increases its magnitude by enhancing negative illness perception, that, in turn, affects sexual dysfunction both directly and through depressive symptoms, especially in pwMS with mild disability. Modulating the effect of illness perception by favoring adaptive coping strategies might represent a valid approach to mitigate sexual dysfunction symptoms in MS.

Chronic demyelination interferes with normal spermatogenesis in cuprizone-intoxicant C57/BL 6 mice: An experimental study

“…The results of the current study revealed that the sperm count and viability percentage, as well as total and progressive motility percentages, were significantly decreased following chronic demyelination and even 5 wk of CPZ withdrawal in the C57/BL 6 mouse model. However, despite sexual dysfunctions being one of the common complaints of MS individuals (28), because of various items like considering sexual deficits as a secondary symptom (3), these issues are highly underdiagnosed (29) and mostly under-investigated (9). Concerning the deteriorative consequences of demyelination on endocrine/sexual and fertility issues, more experimental and clinical investigations should consider these complications in MS individuals (30).…”

“…Although hormonal and sexual disorders are common symptoms in many neurological diseases (8), due to several factors like the complex nature of these symptoms and the influence of other symptoms, sexual and fertility issues are an MS individual challenge that needs more attention and investigation (9). Several hormonal disturbances are the main culprits of men's fertility rate impairment.…”