Research Article| Volume 358, ISSUE 1-2, P317-323, November 15, 2015

Sexual dysfunction in multiple sclerosis: A 6-year follow-up study

Published:September 10, 2015DOI:



      Sexual dysfunction (SD) is a common but often overlooked and undertreated symptom in multiple sclerosis (MS). The purpose of our longitudinal study was to explore the changes in the level of sexual functioning in MS cohort after a period of 3 and 6 years of follow-up, as well as to investigate the predictors of changes in SD during the period of observation.


      The study population comprise a cohort of 93 patients with MS (McDonald's criteria, 2001) who were assessed at three time points during the study (baseline, and at the 3- and 6-year follow-up). The presence and severity of SD was quantified by Szasz sexual functioning scale. Independent predictors of the ordinal-scaled measure of sexual problems were identified using a generalized linear mixed regression models.


      The number of reported SD symptoms increased markedly for both genders during the whole period of observation. Duration of follow-up, age, level of physical disability, depression and fatigue were identified as independent prognostic factors for deterioration of sexual functioning in patients with MS during the 6-year follow-up.


      Our study provides insight into dynamics of change in sexual function among patients with MS and predictors of change, over the period of 6 years.


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        • Lew-Starowicz M.
        • Rola R.
        Sexual dysfunctions and sexual quality of life in men with multiple sclerosis.
        J. Sex Med. 2014; 11: 1294-1301
        • Lew-Starowicz M.
        • Rola R.
        Prevalence of sexual dysfunctions among women with multiple sclerosis.
        Sex. Disabil. 2013; 31: 141-153
        • Guo Z.N.
        • He S.Y.
        • Zhang H.L.
        • Wu J.
        • Yang Y.
        Multiple sclerosis and sexual dysfunction.
        J. Androl. 2012; 14: 530-535
        • Zorzon M.
        • Zivadinov R.
        • Bosco A.
        • Bragadin L.M.
        • Moretti R.
        • Bonfigli L.
        • Morassi P.
        • Iona L.G.
        • Cazzato G.
        Sexual dysfunction in multiple sclerosis: a case–control study. I. Frequency and comparison of groups.
        Mult. Scler. 1999; 5: 418-427
        • Rees P.M1.
        • Fowler C.J.
        • Maas C.P.
        Sexual function in men and women with neurological disorders.
        Lancet. 2007; 369: 512-525
        • Celik D.B.
        • Poyraz E.Ç.
        • Bingöl A.
        • Idiman E.
        • Ozakbaş S.
        • Kaya D.
        Sexual dysfunction in multiple sclerosis: gender differences.
        J. Neurol. Sci. 2013; 324: 17-20
        • Demirkiran M.
        • Sarica Y.
        • Uguz S.
        • Yerdelen D.
        • Aslan K.
        Multiple sclerosis patients with and without sexual dysfunction: are there any differences?.
        Mult. Scler. 2006; 12: 209-214
        • Dachille G.
        • Ludovico G.M.
        • Pagliarulo G.
        • Vestita G.
        Sexual dysfunctions in multiple sclerosis.
        Minerva Urol. Nefrol. 2008; 60: 77-79
        • Tzortzis V1.
        • Skriapas K.
        • Hadjigeorgiou G.
        • Mitsogiannis I.
        • Aggelakis K.
        • Gravas S.
        • Poulakis V.
        • Melekos M.D.
        Sexual dysfunction in newly diagnosed multiple sclerosis women.
        Mult. Scler. 2008; 14: 561-563
        • Koch M.
        • Mostert J.
        • Heerings M.
        • Uyttenboogaart M.
        • De Keyser J.
        Fatigue, depression and disability accumulation in multiple sclerosis: a cross-sectional study.
        Eur. J. Neurol. 2009; 16: 348-352
        • Zemishlany Z.
        • Weizman A.
        The impact of mental illness on sexual dysfunction.
        Adv. Psychosom. Med. 2008; 29: 89-106
        • Marrie R.A.
        • Horwitz R.
        • Cutter G.
        • Tyry T.
        • Campagnolo D.
        • Vollmer T.
        The burden of mental comorbidity in multiple sclerosis: frequent, underdiagnosed, and undertreated.
        Mult. Scler. 2009; 15: 385-392
        • Bronner G.
        • Elran E.
        • Golomb J.
        • Korczyn A.D.
        Female sexuality in multiple sclerosis: the multidimensional nature of the problem and the intervention.
        Acta Neurol. Scand. 2010; 121: 289-301
        • Tepavcevic D.K.
        • Kostic J.
        • Basuroski I.D.
        • Stojsavljevic N.
        • Pekmezovic T.
        • Drulovic J.
        The impact of sexual dysfunction on the quality of life measured by MSQoL-54 in patients with multiple sclerosis.
        Mult. Scler. 2008; 14: 1131-1136
        • Zorzon M.
        • Zivadinov R.
        • Monti Bragadin L.
        • Moretti R.
        • De Masi R.
        • Nasuelli D.
        • Cazzato G.
        Sexual dysfunction in multiple sclerosis: a 2-year follow-up study.
        J. Neurol. Sci. 2001; 187: 1-5
        • Stenager E.
        • Stenager E.N.
        • Jensen K.
        Sexual function in multiple sclerosis. A 5-year follow-up study.
        Ital. J. Neurol. Sci. 1996; 17: 67-69
        • McDonald W.I.
        • Compston A.
        • Edan G.
        • et al.
        Recommended diagnostic criteria for multiple sclerosis: guidelines from the International panel on the diagnosis of multiple sclerosis.
        Ann. Neurol. 2001; 50: 121-127
        • Kurtzke J.F.
        Rating neurologic instrument in multiple sclerosis: an expanded disability status scale (EDSS).
        Neurology. 1983; 33: 1444-1452
        • Szasz G.
        • Paty D.
        • Maurice W.L.
        Sexual dysfunctions in multiple sclerosis.
        Ann. N. Y. Acad. Sci. 1984; 436: 443-452
        • Krupp L.B.
        • Larocca N.G.
        • Nash J.M.
        • Steinberg A.D.
        The fatigue severity scale. Application to patients with multiple sclerosis and systematic lupus erythematosus.
        Arch. Neurol. 1989; 46: 1121-1123
        • Hamilton M.
        Development of a rating scale for primary depressive illness.
        Br. J. Soc. Clin. Psychol. 1967; 6: 278-286
        • Tepavcevic D.K.
        • Pekmezovic T.
        • Stojsavljevic N.
        • Kostic J.
        • Basuroski I.D.
        • Mesaros S.
        • Drulovic J.
        Change in quality of life and predictors of change among patients with multiple sclerosis: a prospective cohort study.
        Qual. Life Res. 2014; 23: 1027-1037
        • Rabe-Hesketh S.
        • Skrondal A.
        • Pickles A.
        Generalized multilevel structural equation modelling.
        Psychometrika. 2004; 69: 167-190
        • Kisic Tepavcevic D.
        • Pekmezovic T.
        • Stojsavljevic N.
        • Kostic J.
        • Dujmovic Basuroski I.
        • Mesaros S.
        • Drulovic J.
        Predictive value of health-related quality of life in progression of disability and depression in persons with multiple sclerosis: a 3-year study.
        Acta Neurol. Belg. 2013; 113: 403-409
        • Lew-Starowicz M.
        • Rola R.
        Correlates of sexual function in male and female patients with multiple sclerosis.
        J. Sex. Med. 2014; 11: 2172-2180
        • Pekmezovic T.
        • Kisic Tepavcevic D.
        • Kostic J.
        • Drulovic J.
        Validation and cross-cultural adaptation of the disease-specific questionnaire MSQoL-54 in Serbian multiple sclerosis patients sample.
        Qual. Life Res. 2007; 16: 1383-1387
        • Stenager E.
        • Stenager E.N.
        • Jensen K.
        Sexual aspects of multiple sclerosis.
        Semin. Neurol. 1992; 12: 120-124
        • Gott M.
        • Galena E.
        • Hinchliff S.
        • Elford H.
        “Opening a can of worms”: GP and practice nurse barriers to talking about sexual health in primary care.
        Fam. Pract. 2004; 21: 528-536
        • Lindau S.T.
        • Schumm L.P.
        • Laumann E.O.
        • Levinson W.
        • O'Muircheartaigh C.A.
        • Waite L.J.
        A study of sexuality and health among older adults in the United States.
        N. Engl. J. Med. 2007; 357: 762-774
        • Taylor A.
        • Gosney M.A.
        Sexuality in older age: essential considerations for healthcare professionals.
        Age Ageing. 2011; 40: 538-543
        • Mohammadi K.
        • Rahnama P.
        • Mohseni S.M.
        • Sahraian M.A.
        • Montazeri A.
        Determinants of sexual dysfunction in women with multiple sclerosis.
        BMC Neurol. 2013; 13: 83
        • Cordeau D.
        • Courtois F.
        Sexual disorders in women with MS: assessment and management.
        Ann. Phys. Rehabil. Med. 2014; 57: 337-347
        • Minderhoud J.M.
        • Leemhuis J.G.
        • Kremer J.
        • Laban E.
        • Smits P.M.
        Sexual disturbances arising from multiple sclerosis.
        Acta Neurol. Scand. 1984; 70: 299-306
        • Fraser C1.
        • Mahoney J.
        • McGurl J.
        Correlates of sexual dysfunction in men and women with multiple sclerosis.
        J. Neurosci. Nurs. 2008; 40: 312-317
        • Bronner G.
        • Vodušek D.B.
        Management of sexual dysfunction in Parkinson's disease.
        Ther. Adv. Neurol. Disord. 2011; 4: 375-383
        • McCabe M.P.
        Exacerbation of symptoms among people with multiple sclerosis: impact on sexuality and relationships over time.
        Arch. Sex. Behav. 2004; 33: 593-601

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