Questionnaire May Help Women Talk About Sexual Health

While sexual problems are relatively common in women with multiple sclerosis (MS), it can still be difficult to openly discuss their experiences with their doctor.

A questionnaire especially tailored for women with MS called the Sexual Dysfunction Management and Expectations Assessment in Multiple sclerosis – Female (SEA-MS-F) may help them discuss these concerns and potential therapies with their doctor, a French study suggests.

The study “Sexual Dysfunction in Women With Multiple Sclerosis: Expectations Regarding Treatment and Information, and Utility of the SEA-MS-F Questionnaire” was published in Sexual Medicine.

Sexual dysfunction is estimated to affect from 40% to 95% of women with MS, with some studies suggesting it “could have greater impact on moral and quality of life than some of the physical impairments caused by MS,” the researchers wrote.

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Yet, while 83% of women with MS have said they would like to discuss sexual problems at their medical appointments, between 63–94% never do.

A team of researchers in France conducted a questionnaire to evaluate the expectations and sexual dysfunction in women with MS. The team used the SEA-MS-F questionnaire, the only one that evaluates patient expectations.

The study’s primary goal was to evaluate MS patients’ expectations regarding treatment and information on sexual dysfunction. Secondary goals included assessing the link between women’s demographic and medical factors with their expectations, as well as the utility of the SEA-MS-F.

The 20-minute questionnaire was composed of eight questions, with each score assigned to one of three grouping that ranged from “low expectations” (score zero to one) to “high expectations” (two to four) to “very high expectations” (three or four). In total, 87 women (mean age 47) diagnosed with MS for a mean of 14 years and attending physical and rehabilitation consultations at four centers in France were included in the study.

More than half (59.8%) reported sexual dysfunction, but only a fraction of them (22.4%) had discussed it with a health professional.

Most women said they were interested in getting more information on sexual dysfunction and potential treatments — 68% percent reported high expectations and 48% very high expectations regarding information about sexual dysfunction.

About the possibility of treating their sexual dysfunction, 80% reported high and 50% very high expectations.

A total of 72.9% had high expectations about treating their low sexual desire, 76.3% for difficulties in sexual arousal, and 74.1% for achieving orgasm. Also, 77.2% expected that treatment for sexual dysfunction would boost their self-esteem.

In 81% of cases, women sought treatment for sexual concerns for themselves, and in 85% of cases for the benefit of their partner and/or as a couple.

Researchers also found that the presence of sexual dysfunction or having discussed it with a health professional were significantly associated with high or very high expectations for information on sexual dysfunction. Having a regular sexual partner and the ability to walk (with or without aid) were associated with high expectations on treatments for sexual dysfunction.

The total SEA-MS-F score was significantly higher for women who reported having experienced sexual problems, had a regular sexual partner, and had already discussed the topic with a health professional.

No correlation was seen between SEA-MS-F scores and demographic factors, including age, post-menopause, time since MS diagnosis, self-reported fatigue levels, or urinary or fecal incontinence.

The SEA-MS-F questionnaire was deemed a useful tool by 83% of participants. A total of 70% of women agreed that it should be used when discussing sexuality with their doctors, and 90% agreed that it would aid in treating sexual dysfunction.

More than half (65.3%) said they preferred that their doctor raise the subject of sexuality and sexual problems. The majority (61.5%) preferred to discuss the matter, while 35.9% preferred to fill out a questionnaire followed by a discussion. Only 10% said they preferred a questionnaire alone.

“To date, the SEA-MS-F is the only questionnaire validated in women with MS for the evaluation of sexual expectations,” the researchers wrote. “In the present study the women felt strongly that [this questionnaire] represented a useful way for them to introduce and then discuss the subject of their sexual dysfunction with their doctor.”

The team also noted that “the discussion between the patient and the doctor with regard to sexuality and sexual function must … also include realistic goal setting as an aim of the treatment.”