Sexual Problems Common Among MS Patients But Often Ignored, Study Reports

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by Diogo Pinto |

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sexual relations and MS

Sexual problems are a frequent but unreported symptom of multiple sclerosis (MS) that affects other symptoms patients experience with this disease, including depression, a study reports.

The study, “Factors associated with sexual dysfunction in individuals with multiple sclerosis,” published in the International Journal of MS Care.

Sexual dysfunction is known to affect MS patients regardless of gender. Recent studies estimate that it affects 40 to 80 percent of women and 50 to 90 percent of men with MS, and evidence of this disorder includes problems with sexual desire, arousal, orgasm, and pain.

Still, such problems are rarely discussed or reported by patients and clinicians. Consequently, sexual dysfunction is not addressed in these patients, affecting their mood, relationships, daily functioning, and quality of life.

A research team at the Cleveland Clinic Foundation investigated the prevalence of sexual dysfunction in a group of MS patients, using a disease-validated questionnaire called the MS intimacy and sexuality questionnaire-19 (MSISQ-19).

“The MSISQ-19 is a 19-item self-report tool that measures sexual dysfunction…and has been validated in the MS population,” the researchers wrote. “An advantage of the MSISQ-19 is that it is quick, taking approximately two minutes to complete, and can be done before any patient visit.”

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The researchers assessed 162 MS patients, mostly woman (126, or 77.8 percent) with a mean age of about 46, who responded to the questionnaire during neurology appointments at the clinic. Mood, disability, and quality of life were also evaluated.

A clear majority — 104 or 64.2 percent of the patients assessed — reported problems in their sexual relations, defined by the research team as “a score of 4 or 5 on any MSISQ-19 item.”

Those with sexual dysfunction were also found to have significantly worse MS-related disabilities, including difficulties with exercise and walking, everyday activities, fatigue and pain, as well as depression.

Antidepressant medication use and a history of behavioral consultations were significantly higher in patients with sexual dysfunction.

No differences were seen in terms of age, income, sex, race, marital status — or in the use of disease-modifying therapies or disease course — between those reporting difficulties with sexual relations and those who did not, a point the researchers took as underscoring sexual dysfunction as a widespread and complex problem in MS, and one that should be addressed.

“Sexual dysfunction is highly prevalent in the MS clinic sample. Assessment and treatment of depression may serve as a starting point for intervention in patients with MS who experience sexual dysfunction,” the researchers wrote, noting that “[m]any antidepressants can include loss of libido and delayed orgasm as common adverse effects.”

“Identifying individuals who are at risk for sexual dysfunction concerns may help with clinical and patient burden in terms of routine assessment of this symptom,” the team concluded.