Multiple sclerosis. Sexual dysfunction and its response to medications.

Abstract

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.