Sexual dysfunction in multiple sclerosis: Gender differences

Purpose: To assess the frequency and nature of sexual dysfunction in multiple sclerosis (MS) patients and to investigate the relationships of SD with clinical, demographic and psychosocial factors by comparing MS patients with and without SD. Methods: Eighty-nine patients were included, 45 males and 44 females, aging an average of 37.4 +/- 8.6 years (range:21-56). We applied Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) and Arizona Sexual Experiences Scale (ASEX) to all patients. Disability was evaluated with the expanded disability status scale (EDSS). Results: 60.7% (n = 54) of patients reported SD according to MSISQ scores. Women exhibited significantly higher MSISQ scores than men (42.6 +/- 12.9 and 36.6 +/- 13.3, respectively; P = 0.034). Women (7.9%) also reported to experience sexual arousal difficulties significantly more than men (1.1%) (P = 0.024) according to ASEX. The patients were classified into three MSISQ-19 subscales, Primary, Secondary and Tertiary SD. The most common reported dimension of SD was secondary (32.5%, n = 41). In this dimension of SD, patients mostly complained of pain-burning, memory-concentration problems and bowel symptoms. A significant relationship was found between Secondary SD and both EDSS score and disease duration (r = 0.34 p = 0.001 and r = 0.21 p = 0.042, respectively). Tertiary SD was also associated with EDSS score (r = 0.23 p = 0.03). Conclusion: Sexual Dysfunction, a frequent problem for MS patients, is associated with gender. Women reported more SD than men. Secondary SD symptoms were the most common complaints for both men and women. Nonetheless women had more secondary SD symptoms than men. The emotional dimension of SD is related with disability. (C) 2012 Elsevier B.V. All rights reserved.