Sexual function in multiple sclerosis and associations with demographic, disease and lifestyle characteristics: an international cross-sectional study

Abstract

BackgroundSexual dysfunction (SD) is very common in people with multiple sclerosis (PwMS) and contributes a significant burden of disease, particularly for young people. SD has direct neurological contributions from depression and fatigue, which occur commonly in PwMS. Modifiable factors may represent potential targets for treatment and prevention of SD. We aimed to assess the prevalence of SD and explore associations between SD and demographic and modifiable risk factors, as well as depression and fatigue in a large cohort of PwMS.MethodsWe analysed self-reported data from a large, international sample of PwMS recruited via Web 2.0 platforms, including demographic, lifestyle and disease characteristics. Specific sexual function questions included 4 items from the sexual function scale and 1 item regarding satisfaction with sexual function, part of the MS Quality of Life-54 instrument.Results2062 PwMS from 54 countries completed questions on sexual function. 81.1 % were women, mean age was 45 years, most (62.8 %) reported having relapsing-remitting MS. The majority (54.5 %) reported one or more problems with sexual function and were classified as having SD. Lack of sexual interest (41.8 % of women), and difficulty with erection (40.7 % of men) were most common. The median total sexual function score was 75.0 out of 100, and 43.7 % were satisfied with their sexual function. Regression modeling revealed independent associations between sexual function and satisfaction and a range of demographic factors, including age, as well as depression risk, antidepressant use, and fatigue in PwMS.ConclusionThis cross-sectional study shows that SD and lack of satisfaction with sexual function are associated with depression risk and fatigue, as well as modifiable lifestyle factors diet and physical activity (after adjusting for depression and fatigue). Planned longitudinal follow-up of this sample may help clarify these associations and the underlying mechanisms. There is potential to prevent and treat SD in PwMS by addressing depression and fatigue and their determinants. Clinicians and PwMS should be aware of SD and associated factors as part of a comprehensive preventive approach to managing MS.

Sexual dysfunction in women with multiple sclerosis: prevalence and impact on quality of life

“…Our study was designed to investigate prevalence and distribution of SD dimensions, and to identify contributory factors for SD in women with MS. The present findings support the results of previous studies, which have shown a high prevalence for sexual dysfunction among women with MS. [1,5,7,32,33]. In a systematic Meta analytic review in Iran (2019), the prevalence of SD was reported as 62% in [34] and as 34 to 85% in a review study in Canada (2014) [35].…”

“…Most MS patients (even those with mild degrees of disability) experience various sexual disorders that affect different aspects of their life significantly, which demonstrates the importance of the early identification and treatment of these disorders [4]. Sexual dysfunction due to MS is more prevalent in women than men, varying from 40 to 80% [5]. Many studies, including ones by Ghajarzadeh (2013), Merghati Khoei (2013) and Mohammadi (2008), have reported the prevalence of SD in Iranian women with MS as 66, 87.1 and 55.3%, respectively [6][7][8].…”

The Prevalence of Sexual Dysfunction in Iranian Women with Multiple

“…These studies have various results and there is no overall estimate of the prevalence of sexual dysfunction in these patients. Given the high prevalence of this disease in Iran, its higher prevalence in women than in men, as well as the impact of sexual dysfunction due to this disease on women's quality of life (16), being aware of the exact level of the prevalence of sexual dysfunction in these patients can help physicians and health planners for design appropriate interventions and treatments.…”

Multiple Sclerosis and Evaluation of Vitamin D Effect

“…Secondary sexual dysfunction is followed by MSrelated problems (such as bladder dysfunction). Tertiary sexual dysfunction occurs under psychosocial effects such as poor body image or low self-esteem [9].…”