SEXUAL DYSFUNCTION IN RELAPSING-REMITTING MULTIPLE-SCLEROSIS - MAGNETIC-RESONANCE-IMAGING, CLINICAL, AND PSYCHOLOGICAL CORRELATES

The purpose of this study was to examine the sexual complaints and sev erity of sexual dysfunction in relapsing-remitting multiple sclerosis patients and to correlate them with psychological, neurological, and r adiological variables, Frequency and characteristics of sexual disturb ances were reported by 41 multiple sclerosis patients (32 females, 9 m ales; mean age 35.4 +/- 10.2 y), Clinical neurologic variables tested were disease duration, exacerbation rate, and disability; psychologica l variables tested were anxiety and depression, All patients underwent a brain magnetic resonance imaging (MRI) scan at the time of this stu dy, The sexual dysfunction questionnaire included items based on the 3 phases of human sexual response: loss of libido, excitement (arousal difficulties, impotence, premature ejaculation), and anorgasmia, Five males (55.5%) and 16 females (50.0%) reported at least 1 sexual distur bance. The most frequent dysfunctions were loss of libido (26.8%) and arousal difficulties (19.5%), Females rated their difficulties as more severe, Sexual dysfunctions correlated with depression, (r = 0.68, P = 0.001), No correlation between MRI score and depression was found. A norgasmia correlated with brain stem and pyramidal abnormalities (r = 0.56, P = 0.011; r = 0.56, P = 0.012, respectively), The total area of lesions (plaques) on the brain MRI scan also correlated with anorgasm ia (r = 0.41, P = 0.02), Sexual dysfunctions in multiple sclerosis pat ients are frequent, are mild to moderate in severity, correlate with d epression and in some cases central nervous system (CNS) demyelinating process, and thus may be related either to the psychological impact o f this disease or to specific organic lesions in the brain.