III Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland.
J Sex Med. 2014 Sep;11(9):2172-80. doi: 10.1111/jsm.12622. Epub 2014 Jun 26.
Many factors have been suggested to contribute to sexual dysfunction (SD) in multiple sclerosis (MS) patients, but the research on their impact on sexual functioning (SF) and sexual quality of life (SQoL) remains scant.
The aim of this study was to investigate correlates of SF and SQoL in MS patients, as well as possible gender differences.
204 MS patients were interviewed, completed the questionnaires, and underwent neurological assessment.
Primary outcome measures included the International Index of Erectile Function, the Female Sexual Function Questionnaire, the Sexual Quality of Life Questionnaire, the Beck Depression Inventory, and the Expanded Disability Status Scale.
The course and duration of the disease did not predict patients' SF. Negative correlations were found for brainstem symptoms with orgasmic function and overall satisfaction in men and between cognitive functioning and the partner domain in women. Interestingly, brainstem symptoms correlated positively with the arousal domain in women. More than half (52.1%) of patients fulfilled Beck Depression Inventory criteria for depression, and these patients showed more SD than nondepressive individuals. The strongest negative correlations with depressive symptoms were found for desire, erectile function, and overall satisfaction with sexual life in men and for orgasm and sexual enjoyment in women. Deterioration in particular domains of SF was clearly related with diminished SQoL. The main gender difference was a strong influence of decreased desire on SQoL in women and no such correlation in men. Negative assessment of the relationship with partner significantly affected all domains of SF and SQoL in MS women and the desire domain in MS men.
Several correlates of SF in MS patients were found. The role of brainstem symptoms needs further investigation. Clinicians should pay close attention to depressive symptoms and relationship factors in MS patients who suffer from SD.
许多因素被认为与多发性硬化症（MS）患者的性功能障碍（SD）有关，但关于这些因素对性功能（SF）和性健康相关生活质量（SQoL）影响的研究仍然很少。
本研究旨在调查 MS 患者 SF 和 SQoL 的相关因素，以及可能存在的性别差异。
对 204 名 MS 患者进行访谈、填写问卷并进行神经学评估。
主要观察指标包括国际勃起功能指数、女性性功能问卷、性健康相关生活质量问卷、贝克抑郁量表和扩展残疾状况量表。
疾病的病程和持续时间并不能预测患者的 SF。脑干症状与男性的性高潮功能和总体满意度以及女性的认知功能与伴侣领域呈负相关。有趣的是，脑干症状与女性的唤醒领域呈正相关。超过一半（52.1%）的患者符合贝克抑郁量表的抑郁标准，这些患者比非抑郁患者表现出更多的 SD。与抑郁症状的相关性最强的是男性的性欲、勃起功能和对性生活的总体满意度，以及女性的性高潮和性享受。SF 特定领域的恶化与 SQoL 的降低明显相关。主要的性别差异是性欲下降对女性 SQoL 的强烈影响，而男性则没有这种相关性。与伴侣关系的负面评价明显影响 MS 女性的 SF 和 SQoL 的所有领域以及 MS 男性的性欲领域。
发现了一些与 MS 患者 SF 相关的因素。脑干症状的作用需要进一步研究。临床医生应密切关注 SD 患者的抑郁症状和与伴侣的关系因素。
