Women with multiple sclerosis (MS) are three times more likely to face problems with sexual intimacy than are their healthy counterparts, according to a recent meta-analysis. About 61% of women with MS were estimated to have some degree of sexual dysfunction, with the most common being low libido, or sexual desire, affecting nearly half of these patients. Findings highlight the significant burden of such problems among people with MS, which patients and their doctors often fail to discuss, the researchers said. The study, "Prevalence and risk of developing sexual dysfunction in women with multiple sclerosis (MS): a systematic review and meta-analysis," was published in BMC Women's Health. Sexual dysfunction due to multiple sclerosis often ignored by doctors. Sexual dysfunction is a common manifestation of MS, thought to arise from a complex interplay of physical, psychological, and social factors. Neurological damage due to MS can inhibit physiological arousal, which may be further exacerbated by secondary MS complications like fatigue, pain, bladder or bowel dysfunction. Depression, anxiety, and other psychosocial factors also can contribute, as can side effects from MS medications. For women, sexual problems may include lack of an orgasm, low libido, vaginal dryness, or increased muscle spasms and tightness (spasticity) during sex. Such symptoms are estimated to affect up to 1 in 4 women with the neurodegenerative disease, who likely are at a higher risk of sexual dysfunction than are women in the general population. "[Sexual dysfunction] is an important issue ... which is ignored by most physicians and patients," the researchers wrote. "It is a multi-dimensional issue which affects quality of life as well as psychological well-being." Researchers in Iran conducted a systematic review and meta-analysis to update the estimated prevalence of sexual issues in women with MS. Their analysis included 56 studies published between 1996 and 2021, all related to sexual dysfunction in MS. Studies were conducted in various countries, with Iranian studies being the most common, followed by those from Italy and Turkey. Patients' mean age ranged from 24.7 to 50.7 across the studies, and a wide range of disability levels were observed. A range of different questionnaires were used to assess sexual dysfunction in patients across the studies. Ultimately, among 8,980 patients, such problems were reported in 4,245 of them. Based on the meta-analysis, the prevalence of sexual dysfunction in women with MS was estimated to be about 61%. Problems identified range from lack of libido to vaginal dryness. The most common complaint was low libido (48%), followed by arousal problems (40%), decreased vaginal lubrication (32%), and a lack of orgasm (29%). About 27% of the women in these MS studies were estimated to be satisfied with sexual intercourse. Seven studies included available data on sexual dysfunction in healthy women. Analyses suggested that women with MS are at a three times higher risk of developing sexual dysfunction compared with healthy adults. The scientists noted that the prevalence of sexual problems identified across individual studies in this meta-analysis varied widely. This divergence is likely related to varying definitions of sexual dysfunction, a lack of standardized assessment tools, different patient inclusion criteria, and cultural differences, they noted. Some studies pointed out factors that were linked to sexual problems in MS, including depression, older age, longer disease duration, and bladder dysfunction. Findings, however, were not always consistent across studies.