Sexual Dysfunction Seems to Trigger Depression in Female Multiple Sclerosis Patients

Abstract

Background: In women with multiple sclerosis (MS), depression and sexual dysfunction (SD) are common. Whether SD promotes depression or vice versa remains unclear despite therapeutic relevance. Therefore, we aimed to assess whether SD more likely triggers depression or vice versa. Methods: In 83 female MS patients and 21 age-matched healthy women, we assessed depression, using the Beck Depression Inventory-V (BDI-V), and SD using the Female Sexual Function Index (FSFI). We diagnosed depression with BDI-V-scores >35 and SD with FSFI scores < 26.55. We divided patients into groups with and without SD, with and without depression. Between groups, we compared prevalence of SD and depression (Fisher’s-exact-test), age, MS-duration, MS-severity, BDI-V-, and FSFI scores (Mann-Whitney U-test; significance: p < 0.05). Results: A total of 37/83 MS patients and 1/21 controls had SD; 28/83 patients and 3/21 controls had depression; 51.4% patients with SD but only 19.6% without SD had depression (p = 0.003). SD was present in 67.9% depressed and 32.7% non-depressed patients. BDI-V-scores were higher in patients with SD than in patients without SD. FSFI scores were lower in depressed than non-depressed patients. Conclusion: In conclusion, SD was more common than depression. SD afflicted 67.9% depressed MS patients and was also more common in non-depressed MS patients than controls. SD may occur independently from depression while increased depressiveness seems linked to coexistent 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 .…”

“…Case‐control studies demonstrated that SD was more commonly reported in MS compared to healthy controls . There were 14 case‐control studies exploring SD in PwMS.…”

“…Mood disorders such as depression, and anxiety, were found to be associated with developing SD. Additionally, a study published in 2019 suggests that SD can trigger depression in PwMS . Depression affects desire, arousal and ability to orgasm, a similar observation as in the general population.…”

“…24 Case-control studies demonstrated that SD was more commonly reported in MS compared to healthy controls. [45][46][47][48][49][50][51][52][53]68 There were 14 case-control studies exploring SD in PwMS. Studies evaluating SD in the general population suggest a lower prevalence of 26% to 47%.…”

“…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).…”