Sexual Medicine Center, Department of Urology, Sheba Medical Center, Tel Hashomer, Israel.
Acta Neurol Scand. 2010 May;121(5):289-301. doi: 10.1111/j.1600-0404.2009.01314.x. Epub 2010 Jan 12.
Female sexual functioning is a complex process involving physiological, psychosocial and interpersonal factors. Sexual dysfunction (SD) is frequent (40-74%) among women with multiple sclerosis (MS), reflecting neurological dysfunction, psychological factors, depression, side effects of medications and physical manifestations of the disease, such as fatigue and muscle weakness. A conceptual model for sexual problems in MS characterizes three levels. Primary SD includes impaired libido, lubrication, and orgasm. Secondary SD is composed of limiting sexual expressions due to physical manifestations. Tertiary SD results from psychological, emotional, social, and cultural aspects. Sexual problems cause distress and may affect the family bond. Practical suggestions on initiation of discussion of sexual issues for MS patients are included in this review. Assessment and treatment of sexual problems should combine medical and psychosexual approaches and begin early after MS diagnosis. Intervention can be done by recognizing sexual needs, educating and providing information, by letting patients express their difficulties and referring them to specialists and other information resources.
女性性功能是一个涉及生理、心理社会和人际关系等多方面的复杂过程。性功能障碍（SD）在多发性硬化症（MS）女性中很常见（40-74%），反映了神经功能障碍、心理因素、抑郁、药物副作用和疾病的身体表现，如疲劳和肌肉无力。MS 中性功能问题的概念模型描述了三个层次。原发性 SD 包括性欲、润滑和性高潮受损。继发性 SD 由身体表现导致的性表达受限组成。三级 SD 是由心理、情感、社会和文化方面造成的。性功能障碍会引起痛苦，并可能影响家庭关系。本文综述了有关 MS 患者性功能问题讨论的启动的实用建议。MS 患者性功能障碍的评估和治疗应结合医学和性心理方法，并在 MS 诊断后尽早开始。干预措施可以通过识别性需求、教育和提供信息来实现，让患者表达他们的困难，并将他们转介给专家和其他信息资源。
