Sexual dysfunction in patients with neuromyelitis optica spectrum disorder

Background: Sexual dysfunction (SD) is a common but poorly understood symptom in patients with neuromyelitis optica spectrum disorder (NMOSD). The study was designed to compare SD between NMOSD patients and healthy controls (FICs), and to investigate factors that influenced SD in NMOSD patients. Methods: The study enrolled 102 sexually active NMOSD patients and 110 HCs. SD was investigated with the Female Sexual Function Inventory (FSFI), the abridged International Index of Erectile Function-5 (IIEF-5) and the Chinese Index of Premature Ejaculation-5 (CIPE-5). Disability, lower urinary tract dysfunction (LUTD), fatigue, depression and anxiety were also evaluated. Results: The prevalence of SD, including female sexual dysfunction (FSD), erectile dysfunction (ED), and premature ejaculation (PE), was significantly higher in NMOSD patients than in HCs (P < .01). The FSFI, IIEF-5 and CIPE-5 scores were all significantly lower in NMOSD patients than in HCs (P < .01). Correlation analysis showed that SD was strongly correlated with age, age at onset, disability, LUTD, fatigue, depression and anxiety (P < .05). Regression analysis further revealed that age at onset (OR = 1.057, P = .036), disability (OR = 1.591, P = .011), and depression (OR = 1.111, P = .041) were independent predictors of FSD in NMOSD patients. Conclusions: This study provided evidence that SD is a common problem in NMOSD patients and that age at onset, disability, and depression are independent predictors of FSD. More attention should be paid to SD in patients with NMOSD.