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Sexual Life Under the Shadow of Multiple Sclerosis in Women: A Qualitative Study in Iran

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Abstract

Sexual life of patients with multiple sclerosis (MS) is a complex and challenging process that is often impaired under the influence of the disease and its neurological, physical and psychosocial complications. Nevertheless, this issue is often neglected. The present study was conducted in Iran to explain sexual life in women with MS and the perception and experience of these women with their sexual life. Eighteen subjects participating in the present qualitative study included 13 women with MS aged 18–50 years presenting to Iran MS Society and 5 key informants. Eligible candidates were selected using purposive sampling with maximum variation. The data were collected by conducting in-depth semi-structured interviews until data saturation was achieved. The data were analyzed in MAXQDA10 using the conventional content analysis based on the approach proposed by Graneheim and Lundman. Three themes and seven categories emerged from analyzing the data. The themes included (1) “declining quality and quantity of sexual relationships” with three categories of “poor sexual function”, “reductions in the frequency of sex” and “fear of recurrence of negative sexual experiences”, (2) “self-neglect in sexual relationships” with two categories of “priority of the spouse in sexual relationships” and “renouncing one’s own rights in sexual relationships” and (3) “low sexual self-efficacy” with two categories of “low sexual self-confidence” and “belief in inability in sexual relationships”. This study highlighted the concern that MS and related complications can significantly and negatively lower the quality and quantity of sexual relationships in women with MS. These women neglect themselves in their sexual life, and experience low sexual self-efficacy. Including these factors in the design and implementation of comprehensive and multidisciplinary interventions appears helpful in promoting the sexual life of these women during their treatment.

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References

  1. Foley, F.W., LaRocca, N.G., Sanders, A.S., Zemon, V.: Rehabilitation of intimacy and sexual dysfunction in couples with multiple sclerosis. Mult. Scler. 7(6), 417–421 (2001)

    PubMed  Google Scholar 

  2. Orasanu, B., Frasure, H., Wyman, A., Mahajan, S.T.: Sexual dysfunction in patients with multiple sclerosis. Mult. Scler. Relat. Disord. 2(2), 117–123 (2013)

    PubMed  Google Scholar 

  3. Bronner, G., Elran, E., Golomb, J., Korczyn, A.: Female sexuality in multiple sclerosis: the multidimensional nature of the problem and the intervention. Acta Neurol. Scand. 121(5), 289–301 (2010)

    PubMed  Google Scholar 

  4. Daneshfar, F., Behboodi-Moghadam, Z., Khakbazan, Z., Nabavi, S.M., Nayeri, N.D., Ghasemzadeh, S., Montazeri, A.: The influence of Ex-PLISSIT (extended permission, limited information, specific suggestions, intensive therapy) model on intimacy and sexuality of married women with multiple sclerosis. Sex. Disabil. 35, 1–16 (2017)

    Google Scholar 

  5. Azami, M., YektaKooshali, M.H., Shohani, M., Khorshidi, A., Mahmudi, L.: Epidemiology of multiple sclerosis in Iran: a systematic review and meta-analysis. PLoS ONE 14(4), e0214738 (2019)

    PubMed  PubMed Central  Google Scholar 

  6. Celik, D.B., Poyraz, E.Ç., Bingöl, A., İdiman, E., Özakbaş, S., Kaya, D.: Sexual dysfunction ın multiple sclerosis: gender differences. J. Neurol. Sci. 324(1), 17–20 (2013)

    PubMed  Google Scholar 

  7. Gumus, H., Akpinar, Z., Yilmaz, H.: Effects of multiple sclerosis on female sexuality: a controlled study. J. Sex. Med. 11(2), 481–486 (2014)

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  9. Ghasemi, V., Simbar, M., Ozgoli, G., Nabavi, S.M., Alavi Majd, H., Mohammad Souri, B., Rashidi Fakari, F., Saei Ghareh Naz, M.: The prevalence of sexual dysfunction in Iranian women with multiple sclerosis: a systematic review and meta-analysis. Shiraz E-Med. J. 20(6), e83490 (2019)

    Google Scholar 

  10. Esmail, S., Munro, B., Gibson, N.: Couple’s experience with multiple sclerosis in the context of their sexual relationship. Sex. Disabil. 25(4), 163–177 (2007)

    Google Scholar 

  11. Flick, U.: An Introduction to Qualitative Research. Sage Publications Limited, Thousand Oaks (2018)

    Google Scholar 

  12. Yılmaz, S.D., Gumus, H., Odabas, F.O., Akkurt, H.E., Yılmaz, H.: Sexual life of women with multiple sclerosis: a qualitative study. Int. J. Sex. Health 29(2), 147–154 (2017)

    Google Scholar 

  13. Dehghan-Nayeri, N., Khakbazan, Z., Ghafoori, F.: “Life behind the mask”: sexual life of Iranian women with multiple sclerosis. Disabil. Health J. 11(2), 274–280 (2017)

    PubMed  Google Scholar 

  14. Safarinejad, M.: Female sexual dysfunction in a population-based study in Iran: prevalence and associated risk factors. Int. J. Impot. Res. 18(4), 382 (2006)

    PubMed  Google Scholar 

  15. Javadivala, Z., Merghati-Khoei, E., Underwood, C., Mirghafourvand, M., Allahverdipour, H.: Sexual motivations during the menopausal transition among Iranian women: a qualitative inquiry. BMC Women's Health 18(1), 191 (2018)

    PubMed  PubMed Central  Google Scholar 

  16. Janghorban, R., Latifnejad Roudsari, R., Taghipour, A., Abbasi, M., Lottes, I.: The shadow of silence on the sexual rights of married Iranian women. Biomed. Res. Int. 2015, 1–11 (2015)

    Google Scholar 

  17. Dehghan-Nayeri, N., Khakbazan, Z., Ghafoori, F., Nabavi, S.M.: Sexual dysfunction levels in iranian women suffering from multiple sclerosis. Mult. Scler. Relat. Disord. 12, 49–53 (2017)

    PubMed  Google Scholar 

  18. Lincoln, Y.S., Guba, E.G.: Naturalistic Inquiry, vol. 75. Sage, Thousand Oaks (1985)

    Google Scholar 

  19. Graneheim, U.H., Lundman, B.: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ. Today 24(2), 105–112 (2004)

    PubMed  Google Scholar 

  20. McCabe, M.P., McKern, S., 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)

    PubMed  Google Scholar 

  21. Merghati-Khoei, E., Qaderi, K., Amini, L., Korte, J.E.: Sexual problems among women with multiple sclerosis. J. Neurol. Sci. 331(1), 81–85 (2013)

    PubMed  PubMed Central  Google Scholar 

  22. Delaney, K.E., Donovan, J.: Multiple sclerosis and sexual dysfunction: a need for further education and interdisciplinary care. NeuroRehabilitation 41(2), 317–329 (2017)

    PubMed  Google Scholar 

  23. Cordeau, D., Courtois, F.: Sexual disorders in women with MS: assessment and management. Ann. Phys. Rehabil. Med. 57(5), 337–347 (2014)

    PubMed  Google Scholar 

  24. McCabe, M.P., McDonald, E., Deeks, A.A., Vowels, L.M., Cobain, M.J.: The impact of multiple sclerosis on sexuality and relationships. J. Sex Res. 33(3), 241–248 (1996)

    Google Scholar 

  25. Zorzon, M., Zivadinov, R., Bosco, A., Bragadin, L.M., Moretti, R., Bonfigli, L., Morassi, P., Iona, L., Cazzato, G.: Sexual dysfunction in multiple sderosis: a case-control study. 1. Frequency and comparison of groups. Mult. Scler. 5(6), 418–427 (1999)

    PubMed  Google Scholar 

  26. Basson, R.: The female sexual response: a different model. J. Sex. Marital. Ther. 26(1), 51–65 (2000)

    PubMed  Google Scholar 

  27. Basson, R., Rees, P., Wang, R., Montejo, A.L., Incrocci, L.: Sexual function in chronic illness. J. Sex. Med. 7(1), 374–388 (2010)

    PubMed  Google Scholar 

  28. Impett, E.A., Gable, S.L., Peplau, L.A.: Giving up and giving in: the costs and benefits of daily sacrifice in intimate relationships. J. Personal. Soc. Psychol. 89(3), 327 (2005)

    Google Scholar 

  29. Khoei, E.M., Whelan, A., Cohen, J.: Sharing beliefs: what sexuality means to Muslim Iranian women living in Australia. Cult. Health Sex. 10(3), 237–248 (2008)

    Google Scholar 

  30. Koch, T., Kralik, D., Eastwood, S.: Constructions of sexuality for women living with multiple sclerosis. J. Adv. Nurs. 39(2), 137–145 (2002)

    PubMed  Google Scholar 

  31. Benjamin, J., Kaplan, V.A.: Sadock Comprehensive Textbook of Psychiatry. Lippincott Williams, Philadelphia (2009)

    Google Scholar 

  32. Steinke, E.E., Wright, D.W., Chung, M.L., Moser, D.K.: Sexual self-concept, anxiety, and self-efficacy predict sexual activity in heart failure and healthy elders. Heart Lung 37(5), 323–333 (2008)

    PubMed  Google Scholar 

  33. Vaziri, S., Lotfi Kashani, F.: Study of factor structure, reliability and validity of the sexual self efficacy questionnaire. Thought Behav. Clin. Psychol. 8(29), 47–56 (2013)

    Google Scholar 

  34. Gagliardi, B.A.: The experience of sexuality for individuals living with multiple sclerosis. J. Clin. Nurs. 12(4), 571–578 (2003)

    PubMed  Google Scholar 

  35. Kindrat, S.G.: The Relationship Between Body Image and Depression in Women Diagnosed with Relapsing Remitting Multiple Sclerosis. Faculty of Nursing, University of Calgary, Calgary (2005)

    Google Scholar 

  36. Barak, Y., Lampl, Y., Sarova-Pinchas, I., Achiron, A.: Self and body esteem perception in multiple sclerosis. Behav. Neurol. 11(3), 159–161 (1999)

    PubMed  Google Scholar 

  37. Alirezaei, S., Ozgoli, G., Majd, H.A.: Evaluation of factors associated with sexual function in infertile women. Int. J. Fertil. Steril. 12(2), 125 (2018)

    PubMed  PubMed Central  Google Scholar 

  38. Ghasemi, V., Simbar, M., Ozgoli, G., Nabavi, S.M., Alavi-Majd, H., Mirshafaei, M.S.: Sexual self-efficacy and its predictor factors in women with multiple sclerosis. J. Isfahan Med. School 37(526), 508–516 (2019)

    Google Scholar 

  39. Assarzadeh, R., Bostani Khalesi, Z., Jafarzadeh-Kenarsari, F.: Sexual self-efficacy and associated factors: a review. Shiraz E-Med. J. 20(11), e87537 (2019)

    Google Scholar 

  40. Fraser, C., MSCN, M.K.: The relationship between self-efficacy, self-esteem, hope, and disability in individuals with multiple sclerosis. In: 16th International nursing research congress Hawaii, USA (2005)

  41. Mikula, P., Nagyova, I., Vitkova, M., Szilasiova, J.: Management of multiple sclerosis: the role of coping self-efficacy and self-esteem. Psychol. Health Med. 23(8), 964–969 (2018)

    PubMed  Google Scholar 

  42. Raisi, F., Yekta, Z.P., Ebadi, A., Shahvari, Z.: What are Iranian married women's rewards? Using interpersonal exchange model of sexual satisfaction: a qualitative study. Sex. Relatsh. Ther. 30(4), 475–489 (2015)

    Google Scholar 

  43. Cook, J.E., Germano, A.L., Stadler, G.: An exploratory investigation of social stigma and concealment in patients with multiple sclerosis. Int. J. MS Care 18(2), 78–84 (2016)

    PubMed  PubMed Central  Google Scholar 

  44. Kalantari, S., Karbakhsh, M., Kamiab, Z., Kalantari, Z., Sahraian, M.A.: Perceived social stigma in patients with multiple sclerosis: a study from Iran. Acta Neurol. Taiwan. 27(1), 1–8 (2018)

    PubMed  Google Scholar 

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Acknowledgements

This study was approved by the Ethics Committee of Shahid Beheshti University of Medical Sciences as a part of the Ph.D. thesis of Vida Ghasemi, Ph.D. candidate of reproductive health in Shahid Beheshti University of Medical Sciences. We are also grateful to Shahid Beheshti University of Medical Sciences for founding the research, all participants and personnel of the Iran MS Society and individuals who cooperate with us to conduct this study.

Funding

This research was funded and supported by Shahid Beheshti University of Medical Sciences (Grant No. 15666).

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Authors and Affiliations

  1. Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Vida Ghasemi

  2. Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Masoumeh Simbar & Giti Ozgoli

  3. Regenerative Biomedicine Department, Neurology and MS Group, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran

    Seyed Massood Nabavi

  4. Department of Brain and Cognitive Sciences, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran

    Seyed Massood Nabavi

  5. Department of Biostatics, School of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Hamid Alavi Majd

Authors
  1. Vida Ghasemi
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  2. Masoumeh Simbar
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  4. Seyed Massood Nabavi
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Correspondence to Masoumeh Simbar.

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Ghasemi, V., Simbar, M., Ozgoli, G. et al. Sexual Life Under the Shadow of Multiple Sclerosis in Women: A Qualitative Study in Iran. Sex Disabil 38, 715–730 (2020). https://doi.org/10.1007/s11195-020-09626-3

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