Skip to main content

Advertisement

SpringerLink
Log in

Prevalence of Sexual Dysfunction Among Greek MS Patients

  • Original Paper
  • Published:
Sexuality and Disability Aims and scope Submit manuscript

Abstract

Multiple Sclerosis (MS) can complicate the lifelong course of sexual development and the ways in which one defines and expresses one’s sexuality. The aim of the present study was to register, examine and categorize sexual dysfunction (SD) among Greek patients with MS. 866 individuals, all Greek MS patients members of MS societies all over Greece completed the Greek version of MSISQ-15 along with demographic data. The sample of 866 participants was composed by 66.5% of women and 33.5% of men. SD was present in both sexes in high levels with women having higher scores in Primary SD and men having higher scores in the other two subscales. For the case of Primary SD there was a collective significant effect between Gender, Age and duration of MS, and prevalence of SD. The same stands for the case of Secondary SD. In the case of the Tertiary SD, Gender was the only significant predictor of prevalence of SD. Results of the regression model for the total Score of SD revealed a significant positive relation between Age and MS Duration with the prevalence of SD. Also, there was a strong negative effect on prevalence of SD moderated by Age and MS Duration. SD is present in Greek MS patients in high rates in both sexes with age, MS duration and gender being the main predictors. Awareness of SD in patients with MS is essential for successful evaluation and management. Clinicians working with MS should proactively ask their patients about their sexual life in order to provide suggestions and solutions about these issues or a referral to a sex specialist.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Foley, F.W., Werner, M.: Sexuality and Intimacy. In: Kalb, R.C. (ed.) Multiple Sclerosis: The Questions You Ask. The Answers You Need, 2nd edn. Demos Vermonde Press, New York (2000)

    Google Scholar 

  2. Rees, P.M., Fowler, C.J., Maas, C.P.: Sexual function in men and women with neurological disorders. Lancet 369, 512–525 (2007)

    Article  Google Scholar 

  3. Bronner, G., Elran, E., Golomb, J., Korczyn, A.D.: Female sexuality in multiple sclerosis: the multidimensional nature of the problem and the intervention. Acta Neurol. Scand. 121, 289–301 (2010). https://doi.org/10.1111/j.1600-0404.2009.01314.x

    Article  Google Scholar 

  4. Nortvedt, M.W., Riise, T., Frugaård, J., Mohn, J., Bakke, A., Skår, A.B., et al.: Prevalence of bladder, bowel and sexual problems among multiple sclerosis patients two to five years after diagnosis. Mult. Scler. J. 13(1), 106–112 (2007)

    Article  Google Scholar 

  5. Guo, Z.N., He, S.Y., Zhang, H.L., Wu, J., Yang, Y.: Multiple sclerosis and sexual dysfunction. Asian J. Androl. 14(4), 530 (2012)

    Article  Google Scholar 

  6. Fraser, C., Mahoney, J., McGurl, J.: Correlates of sexual dysfunction in men and women with multiple sclerosis. J. Neurosci. Nurs. 40(5), 312–317 (2008)

    Article  Google Scholar 

  7. Kessler, T.M., Fowler, C.J., Panicker, J.N.: Sexual dysfunction in multiple sclerosis. Expert Rev. Neurother. 9(3), 341–350 (2009)

    Article  Google Scholar 

  8. Schmidt, E.Z., Hofmann, P., Niederwieser, G., Kapfhammer, H.P., Bonelli, R.M.: Sexuality in multiple sclerosis. J. Neural Transm. (Vienna) 112(9), 1201–1211 (2005)

    Article  Google Scholar 

  9. Drulovic, J., Kisic-Tepavcevic, D., Pekmezovic, T.: Epidemiology, diagnosis and management of sexual dysfunction in multiple sclerosis. Acta Neurol. Belg. (2020). https://doi.org/10.1007/s13760-020-01323-4

    Article  Google Scholar 

  10. Adamec, I., Habek, M.: Autonomic dysfunction in multiple sclerosis. Clin. Neurol. Neurosurg. 115S, S73–S78 (2013)

    Article  Google Scholar 

  11. Murray, T.J.: Multiple Sclerosis: The History of a Disease. Demos Publishing, NY (2005)

    Google Scholar 

  12. Konstantinides, C., Tzitzika, M., Bantis, A., Nikolia, A., Samarinas, M., Kratiras, Z., Thomas, C., Skriapas, K.: Female sexual dysfunction among greek women with multiple sclerosis: correlations with organic and psychological factors. Sex Med. 7(1), 19–25 (2019). https://doi.org/10.1016/j.esxm.2018.11.003

    Article  Google Scholar 

  13. Tepavcevic, D.K., Kostic, J., Basuroski, I.D., Stojsavljevic, N., Pekmezovic, T., Drulovic, J.: The impact of sexual dysfunction on the quality of life measured by MSQoL-54 in patients with multiple sclerosis. Mult. Scler. J. 14(8), 1131–1136 (2008). https://doi.org/10.1177/1352458508093619

    Article  Google Scholar 

  14. Delaney, K.E., Donovan, J.: Multiple sclerosis and sexual dysfunction: a need for further education and interdisciplinary care. NeuroRehabilitation 41, 317–329 (2017). https://doi.org/10.3233/NRE-172200

    Article  Google Scholar 

  15. Donze, C., Hautecoeur, P.: Urinary, sexual, and bowel disorders in early-stage multiple sclerosis. Revue Neurol. 165, S148–S155 (2009). https://doi.org/10.1016/S0035-3787(09)72127-7

    Article  Google Scholar 

  16. Zorzon, M., Zivadinov, R., Bosco, A., Bragadin, L.M., Moretti, R., Bonfigli, L., et al.: Sexual dysfunction in multiple sderosis: a case-control study—frequency and comparison of groups. Mult. Scler. J. 5(6), 418–427 (1999)

    Google Scholar 

  17. Laumann, E.O., Glasser, D.B., Neves, R.C.S., Moreira, E.D., GSSAB Investigators’ Group: A population-based survey of sexual activity, sexual problems and associated help-seeking behavior patterns in mature adults in the United States of America. Int. J. Impot. Res. 21(3), 171–178 (2009)

    Article  Google Scholar 

  18. Laumann, E.O., Nicolosi, A., Glasser, D.B., Paik, A., Gingell, C., Moreira, E., Wang, T., EGSSAB Investigators Group: Sexual problems among women and men aged 40–80 y: prevalence and correlates identified in the global study of sexual attitudes and behaviors. Int. J. Impot. Res. 17(1), 39–57 (2005)

    Article  Google Scholar 

  19. McCabe, M.P.: Relationship functioning and sexuality among people with multiple sclerosis. J. Sex Res. 39(4), 302–309 (2002). https://doi.org/10.1080/00224490209552154

    Article  Google Scholar 

  20. Minderhoud, J.M., Leemhuis, J.G., Kremer, J., Laban, E., Smits, P.M.: Sexual disturbances arising from multiple sclerosis. Acta Neurol. Scand. 70(4), 299–306 (2002)

    Article  Google Scholar 

  21. Valleroy, M.L., Kraft, G.H.: Sexual dysfunction in multiple sclerosis. Arch. Phys. Med. Rehabil. 65(3), 125–128 (1984)

    Google Scholar 

  22. Tzortzis, V., Skriapas, K., Hadzigeorgiou, G., Mitsogiannis, I., Aggelakis, K., Gravas, S., et al.: Sexual dysfunction in newly diagnosed multiple sclerosis women. Mult. Scler. 14(4), 561–563 (2008). https://doi.org/10.1177/13524585080140040901

    Article  Google Scholar 

  23. Schairer, L., Foley, F.W., Zemon, V., Campagnolo, D., Tyry, T., Marrie, R., Scharer, D.: The impact of sexual dysfunction on health-related quality of life in people with multiple sclerosis. Mult. Scler. 20(5), 610–616 (2014)

    Article  Google Scholar 

  24. Cristopherson, J.M., Moore, K., Foley, F.W., Warren, K.G.: A comparison of written materials vs. materials and counseling for women with sexual dysfunction and multiple sclerosis. J. Clin. Nurs. 15, 742–750 (2006)

    Article  Google Scholar 

  25. Lew-Starowicz, M., Rola, R.: Prevalence of sexual dysfunctions among women with multiple sclerosis. Sex. Disabil. 31, 141 (2013). https://doi.org/10.1007/s11195-013-9293-9

    Article  Google Scholar 

  26. Marck, C.H., Jelinek, P.L., Weiland, T.J., De Hocking, J.S., Livera, A.M., Taylor, K.L., Jelinek, G.A.: Sexual function in multiple sclerosis and associations with demographic disease and lifestyle characteristics: an international cross-sectional study. BMC Neurol. 16(1), 210 (2016)

    Article  Google Scholar 

  27. Foley, F.W., Werner, M.: How MS affects sexuality and intimacy. In: Kalb, R.C. (ed.) Multiple Sclerosis: The Questions You Ask. The Answers You Need, 4th edn, pp. 172–198. Demos Medical Publishing, New York (2007)

    Google Scholar 

  28. Foley, F.W., Zemon, V., Campagnolo, D., Devitt, M., Tyry, T., Marrie, R., Cutter, G., Sipski, M.L., Vollmer, T.: The epidemiology of sexual dysfunction in the United States. In: Platform Presentation at the 21st Annual Meeting of the Consortium of Multiple Sclerosis Centers. Washington, DC

  29. Calabrò, R.S., De Luca, R., Conti-Nibali, V., Reitano, S., Leo, A., Bramanti, P.: Sexual dysfunction in male patients with multiple sclerosis: a need for counselling! Int. J. Neurosci. 124(8), 547–557 (2014)

    Article  Google Scholar 

  30. Lew-Starowicz, M., Rola, R.: Correlates of sexual function inmale and female patients with multiple sclerosis. J. Sex. Med. 11(9), 2172–2180 (2014)

    Article  Google Scholar 

  31. Hösl, K.M., Deutsch, M., Wang, R., Roy, S., Winder, K., Niklewski, G., Hilz, M.J.: Sexual dysfunction seems to trigger depression in female multiple sclerosis patients. Eur. Neurol. (2018). https://doi.org/10.1159/000492126

    Article  Google Scholar 

  32. Ashtari, F., Rezvani, R., Afshar, H.: Sexual dysfunction in women with multiple sclerosis: dimensions and contributory factors. J. Res. Med. Sci. 19(3), 228–233 (2014)

    Google Scholar 

  33. Demirkiran, M., Sarica, Y., Uguz, S., Yerdelen, D., Aslan, K.: Multiple sclerosis patients with and without sexual dysfunction: are there any differences? Mult. Scler. 12(2), 209–214 (2006)

    Article  Google Scholar 

  34. Koch, T., Kralik, D., Eastwood, S.: Constructions of sexuality for women living with multiple sclerosis. J. Adv. Nurs. 39, 137–145 (2002)

    Article  Google Scholar 

  35. McCabe, M.P., McKern, S.M., McDonald, E., Vowels, L.M.: Changes over time in sexual and relationship functioning of people with multiple sclerosis. J. Sex Marital Ther. 29(4), 305–321 (2003). https://doi.org/10.1080/00926230390195506-2372

    Article  Google Scholar 

  36. Celik, D.B., Poyraz, E.Ç., Bingöl, A., Idiman, E., Ozakbaş, S., Kaya, D.: Sexual dysfunction in multiple sclerosis: gender differences. J. Neurol. Sci. 324(1–2), 17–20 (2013). https://doi.org/10.1016/j.jns.2012.08.019

    Article  Google Scholar 

  37. Zivadinov, R., Zorzon, M., Bosco, A., Bragadin, L.M., Moretti, R., Bonfigli, L., et al.: Sexual dysfunction in multiple sclerosis: II. Correlation analysis. Mult. Scler. 5(6), 428–431 (1999)

    Google Scholar 

  38. Valleroy, M.L., Kraft, G.H.: Sexual disturbances arising from multiple sclerosis. Acta Neurol. Scand. 70(4), 299–306 (1984)

    Google Scholar 

  39. Azimi, A., Hanaei, S., Sahraian, M.A., Mohammadifar, M., Ramagopalan, S.V., Chajarzadeh, M.: Prevalence of sexual dysfunction in women with multiple sclerosis: a systematic review and meta-analysis. Maedica J. Clin. Med. 14(4), 408–412 (2019). https://doi.org/10.26574/maedica.2019.14.4.408

    Article  Google Scholar 

  40. Tzitzika, M., Daoultzis, C.C., Konstantinidis, C., Kordoutis P.: The multiple sclerosis intimacy and sexuality questionnaire (MSISQ-15): validation and cross-cultural adaptation of the Greek version in MS patients. Sex. Disabil. https://doi.org/10.1007/s11195-020-09635-2

  41. Foley, F.W., Zemon, V., Campagnolo, D., Marrie, R.A., Cutter, G., Tyry, T., et al.: The multiple sclerosis intimacy and sexuality questionnaire: re-validation and development of a 15-item version with a large US sample. Mult. Scler. 19(9), 1197–1203 (2013). https://doi.org/10.1177/1352458512471876

    Article  Google Scholar 

  42. Sanders, A.S., Foley, F.W., LaRocca, N.G., et al.: The multiple sclerosis intimacy and sexuality questionnaire-19 [MSISQ-19]. Sex. Disabil. 18, 3–26 (2000)

    Article  Google Scholar 

  43. Bartnik, P., Wielgoś, A., Kacperczyk, J., et al.: Sexual dysfunction in female patients with relapsing-remitting multiple sclerosis. Brain Behav. 00, e00699 (2017). https://doi.org/10.1002/brb3.699

    Article  Google Scholar 

  44. Darija, K.T., Tatjana, P., Goran, T., Nebojsa, S., Irena, D., Sarlota, M., Jelene, D.: Sexual dysfunction in multiple sclerosis: a 6-year follow-up study. J. Neurol. Sci. 358, 317–323 (2015)

    Article  Google Scholar 

  45. Merghati-Khoei, E., Qaderi, K., Amini, L., Korte, J.E.: Sexual problems among women with multiple sclerosis. J. Neurol. Sci. 331, 81–85 (2013)

    Article  Google Scholar 

  46. Mohammadi, K., Rahnama, P., Mohseni, S.M., Sahraian, M.A., Montazeri, A.: Determinants of sexual dysfunction in women with multiple sclerosis. BMC Neurol. 13, 83 (2013)

    Article  Google Scholar 

  47. Webster, D.: Recontextualizing sexuality in chronic illness: women and interstitial cystitis. Health Care Women Int. 18, 575–589 (1997)

    Article  Google Scholar 

  48. Cyranowski, J.M., Frank, E., Young, E., Shear, M.K.: Adolescent onset of the gender difference in lifetime rates of major depression: a theoretical model. Arch. Gen. Psychiatry 57(1), 21–27 (2000)

    Article  Google Scholar 

  49. Cairney, J., Wade, T.J.: The influence of age on gender differences in depression: further population-based evidence on the relationship between menopause and the sex difference in depression. Soc. Psychiatry Psychiatr. Epidemiol. 37(9), 401–408 (2002)

    Article  Google Scholar 

  50. Biljl, R.V., DeGraaf, R., Ravelli, A., Smit, F., Vollebergh, W.A.: Gender and age-specific first incidence of DSM-III-R psychiatric disorders in the general population. Results from the Netherland Mental Health Survey and Incidence Study (NEMESIS). Soc. Psychiatry Psychiatr. Epidemiol. 37(8), 372–379 (2002)

    Article  Google Scholar 

  51. Kessler, R.C.: Epidemiology of women and depression. J. Affect. Disord. 74(1), 5–13 (2003)

    Article  Google Scholar 

  52. Leach, L.S., Christensen, H., Mackinnon, A.J., Windsor, T.D., Butterworth, P.: Gender differences in depression and anxiety across the adult lifespan: the role of psychosocial mediators. Soc. Psychiatry Psychiatr. Epidemiol. 43(12), 983–998 (2008)

    Article  Google Scholar 

  53. Faravelli, C., Alessandra Scarpato, M., Castellini, G., Lo Sauro, C.: Gender differences in depression and anxiety: the role of age. Psychiatry Res. 210(3), 1301–1303 (2013). https://doi.org/10.1016/j.psychres.2013.09.027

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank the Greek Federation of Persons with Multiple Sclerosis for giving us the permission to address to MS patients all over Greece.

Funding

None.

Author information

Authors and Affiliations

  1. Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece

    M. Tzitzika, D. Kalamaras & P. Kordoutis

  2. Urology and Neuro-urology Unit, National Rehabilitation Center, Ilion, Athens, Greece

    M. Tzitzika

Authors
  1. M. Tzitzika
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. Kalamaras
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Kordoutis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Tzitzika.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tzitzika, M., Kalamaras, D. & Kordoutis, P. Prevalence of Sexual Dysfunction Among Greek MS Patients. Sex Disabil 38, 637–651 (2020). https://doi.org/10.1007/s11195-020-09662-z

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11195-020-09662-z

Keywords

Search

Navigation