MULTIPLE-SCLEROSIS - SEXUAL DYSFUNCTION AND ITS RESPONSE TO MEDICATIONS

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 perce nt of patients reported that they had less sexual activity, and 35% sa id that they had less interest in lovemaking than before their diagnos is of MS. Fifty-seven patients reported that they had problems with se xual dysfunction. Sexual dysfunction preceded the diagnosis of MS in o nly 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 lu brication, and both sexes had problems with decreased sensation and ac hieving orgasm. The presence of sexual dysfunction was associated with the presence of urinary problems (P=.02) and with a history of treatm ent of (P=.04) or a current report of (P=.02) depression. No associati on could be found between sexual dysfunction and duration of disease, type of disease, disability score, or presence of fatigue. Twenty of 5 7 patients with sexual dysfunction reported that they had associated m arital problems. Forty-three of 60 patients who discussed sexual probl ems with their spouses and four of six who tried formal counseling fou nd it helpful. Surprisingly, corticosteroid treatments that were start ed for problems other than sexual dysfunction resulted in improved sex ual functioning in many patients. Conclusions: Sexual dysfunction is c ommon in patients with MS. Determining the frequency and nature of pro blems allows issues of sexual dysfunction to be addressed as part of c omprehensive care of patients with MS and suggests treatments that cou ld improve their quality of life.