Multiple sclerosis. Sexual dysfunction and its response to medications
D. Mattson, M. Petrie, D. K. Srivastava and M. McDermott
Department of Neurology, University of Rochester (NY) School of Medicine and Dentistry, USA.
OBJECTIVE: To determine the frequency and nature of sexual dysfunction, as
well as its response to medications, in a sample of patients with multiple
sclerosis (MS). DESIGN: Retrospective and prospective survey of 65 female
and 36 male patients with MS. RESULTS: Sixty-three percent of patients
reported that they had less sexual activity, and 35% said that they had
less interest in lovemaking than before their diagnosis of MS. Fifty-seven
patients reported that they had problems with sexual dysfunction. Sexual
dysfunction preceded the diagnosis of MS in only 10 of these patients. A
higher percentage of men (78%) than women (45%) reported that they
experienced sexual dysfunction (P = .002). Men had prominent erectile
dysfunction, women had problems with vaginal lubrication, and both sexes
had problems with decreased sensation and achieving orgasm. The presence of
sexual dysfunction was associated with the presence of urinary problems (P
= .02) and with a history of treatment of (P = .04) or a current report of
(P = .02) depression. No association could be found between sexual
dysfunction and duration of disease, type of disease, disability score, or
presence of fatigue. Twenty of 57 patients with sexual dysfunction reported
that they had associated marital problems. Forty-three of 60 patients who
discussed sexual problems with their spouses and four of six who tried
formal counseling found it helpful. Surprisingly, corticosteroid treatments
that were started for problems other than sexual dysfunction resulted in
improved sexual functioning in many patients. CONCLUSIONS: Sexual
dysfunction is common in patients with MS. Determining the frequency and
nature of problems allows issues of sexual dysfunction to be addressed as
part of comprehensive care of patients with MS and suggests treatments that
could improve their quality of life.
