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Sexual Dysfunction in Multiple Sclerosis

Abstract

To describe sexual dysfunction (SD) in persons with MS, its impact on quality of life and relationship with bladder function. Persons with definite MS (n = 73) from a tertiary hospital database, interviewed using standardized measures. For disability: Neurological Disability Scale (NDS), American Urological Association Index, Urogenital Distress Inventory (UDI6), Incontinence Impact Questionnaire (IIQ7) and Personal Experiences Questionnaire (PEQ); participation: Multiple Sclerosis Impact Scale (MSIS). Mean age 50 years, 73% female, 52% progressive MS and 60% with detrusor overactivity. Fifty-one (72%) had PEQ scores indicating SD. Women reported greater SD than men (p = .013). SD included: lack of enjoyment of sexual activity (32%), failure of arousal (30%) and anorgasmia (47%). Patients who reported MS impacted ‘a great deal ‘on their sex lives, compared with those who did not, showed significant differences on PEQ Sexual Frequency (p = .01), IIQ7 (p = .03), UDI6 (p = .04) and both MSIS subscales (Physical p = .04; Psychological p = .03). The PEQ Sexual Frequency scale significantly correlated with NDS (rho = −.30), QoL Bladder score (rho = −.35) and MSIS Physical subscale (rho = −.30). No association was found between SD and age, years since diagnosis, stage or severity of MS. SD is complex and often overlooked in clinical care. Improved management options for SD may improve QoL in these persons.

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References

  1. 1.

    Foley, F.W., Sanders, A.: Sexuality, multiple sclerosis and women. Mult. Scler. Manag. 1, 1–9 (1997)

  2. 2.

    Foley, F., Gimbel, B.: Introduction to intimacy and sexuality in MS. MS in focus, vol. 6, pp. 4–5. Cambridge Publishers Ltd, Cambridge (2005)

  3. 3.

    Secil, Y., Yetimalar, Y., Gedizlioglu, M., Arpaci, E., Tokucoglu, F., Inceoglu Kendir, A., et al.: Sexual dysfunction and sympathetic skin response recorded from the genital region in women with multiple sclerosis. Mult. Scler. 13(6), 742–748 (2007)

  4. 4.

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

  5. 5.

    Hulter, B.M., Lundberg, P.O.: Sexual function in women with advanced multiple sclerosis. J. Neurol. Neurosurg. Psychiatry 59(1), 83–86 (1995)

  6. 6.

    Nortvedt, M.W., Riise, T., Myhr, K.M., Landtblom, A.M., Bakke, A., Nyland, H.I.: Reduced quality of life among multiple sclerosis patients with sexual disturbance and bladder dysfunction. Mult. Scler. 7(4), 231–235 (2001)

  7. 7.

    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)

  8. 8.

    Gruenwald, I., Vardi, Y., Gartman, I., Juven, E., Sprecher, E., Yarnitsky, D., et al.: Sexual dysfunction in females with multiple sclerosis: quantitative sensory testing. Mult. Scler. 13(1), 95–105 (2007)

  9. 9.

    Borello-France, D., Leng, W., O’Leary, M., Xavier, M., Erickson, J., Chancellor, M.B., et al.: Bladder and sexual function among women with multiple sclerosis. Mult. Scler. 10(4), 455–461 (2004)

  10. 10.

    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. 14(8), 1131–1136 (2008)

  11. 11.

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

  12. 12.

    Khan, F., McPhail, T., Brand, C., Turner-Stokes, L., Kilpatrick, T.: Multiple sclerosis: disability profile and quality of life in an Australian community cohort. Int. J. Rehabil. Res. 29(2), 87–96 (2006)

  13. 13.

    Khan, F., Pallant, J.F., Shea, T.L., Whishaw, M.: Multiple sclerosis: prevalence and factors impacting bladder and bowel function in an Australian community cohort. Disabil. Rehabil. 31(19), 1567–1576 (2009)

  14. 14.

    McDonald, W.I., Compston, A., Edan, G., Goodkin, D., Hartung, H.P., Lublin, F.D., et al.: Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann. Neurol. 50(1), 121–127 (2001)

  15. 15.

    Kurtzke, J.F.: Rating neurologic impairment in multiple sclerosis: an Expanded Disability Status Scale (EDSS). Neurology 33(11), 1444–1452 (1983)

  16. 16.

    Sharrack, B., Hughes, R.A.: The Guy’s Neurological Disability Scale (GNDS): a new disability measure for multiple sclerosis. Mult. Scler. 5(4), 223–233 (1999)

  17. 17.

    Barry, M.J., Fowler Jr., F.J., O’Leary, M.P., Bruskewitz, R.C., Holtgrewe, H.L., Mebust, W.K., et al.: The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J. Urol. 148(5), 1549–1557 (1992). (discussion 64)

  18. 18.

    Shumaker, S.A., Wyman, J.F., Uebersax, J.S., McClish, D., Fantl, J.A.: Health-related quality of life measures for women with urinary incontinence: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory Continence Program in Women (CPW) Research Group. Qual. Life Res. 3(5), 291–306 (1994)

  19. 19.

    Uebersax, J.S., Wyman, J.F., Shumaker, S.A., McClish, D.K., Fantl, J.A.: Short forms to assess life quality and symptom distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group. Neurourol. Urodyn. 14(2), 131–139 (1995)

  20. 20.

    Brown, J.S., Posner, S.F., Stewart, A.L.: Urge incontinence: new health-related quality of life measures. J. Am. Geriatr. Soc. 47(8), 980–988 (1999)

  21. 21.

    Dennerstein, L., Lehert, P., Dudley, E.: Short scale to measure female sexuality: adapted from McCoy Female Sexuality Questionnaire. J. Sex Marital Ther. 27(4), 339–351 (2001)

  22. 22.

    McCoy, N.L.: The McCoy Female Sexuality Questionnaire. Qual. Life Res. 9, 739–745 (2000)

  23. 23.

    Hobart, J.C., Riazi, A., Lamping, D.L., Fitzpatrick, R., Thompson, A.J.: How responsive is the Multiple Sclerosis Impact Scale (MSIS-29)? A comparison with some other self report scales. J. Neurol. Neurosurg. Psychiatry 76(11), 1539–1543 (2005)

  24. 24.

    Nunnally, J.C.: Psychometric theory. McGraw-Hill, New York (1978)

  25. 25.

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

  26. 26.

    Mattson, D., Petrie, M., Srivastava, D.K., McDermott, M.: Multiple sclerosis. Sexual dysfunction and its response to medications. Arch. Neurol. 52(9), 862–868 (1995)

  27. 27.

    Barak, Y., Achiron, A., Elizur, A., Gabbay, U., Noy, S., Sarova-Pinhas, I.: Sexual dysfunction in relapsing-remitting multiple sclerosis: magnetic resonance imaging, clinical, and psychological correlates. J. Psychiatry Neurosci. 21(4), 255–258 (1996)

  28. 28.

    Aisen ML, Sanders AS: Sexual dysfunction in neurologic disease: mechanisms of disease and counseling approaches. AUA update Series Lesson 35 [serial on the Internet]. XV11 (1998)

  29. 29.

    Sanders, A.S., Foley, F.W., LaRocca, G.I., Zemon, V.T.: The multiple sclerosis Intimacy and Sexuality Questionnire 19 (MSISQ-19). Sex. Disabil. 18, 3–26 (2000)

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Acknowledgments

We thank all persons with MS who participated in this study. We are also grateful to L Oscari for conducting the interviews.

Conflict of Interest

None.

Author information

Correspondence to Fary Khan.

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Cite this article

Khan, F., Pallant, J.F., Ng, L. et al. Sexual Dysfunction in Multiple Sclerosis. Sex Disabil 29, 101–111 (2011). https://doi.org/10.1007/s11195-011-9198-4

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Keywords

  • Multiple sclerosis
  • Bladder
  • Sexual dysfunction
  • Participation
  • Multiple Sclerosis Impact Scale
  • Neurological Disability Scale