Salhofer-Polanyi Sabine, Wöber Christian, Prohazka Ricarda, Dal-Bianco Assunta, Bajer-Kornek Barbara, Zebenholzer Karin
Medical University of Vienna, Vienna, Austria.
Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Wien Klin Wochenschr. 2017 Feb;129(3-4):115-120. doi: 10.1007/s00508-016-1066-x. Epub 2016 Sep 5.
Sexuality is an integral part of overall health but the impact of neurological diseases on sexual function still receives too little attention.
The aim of this case control study was to compare frequencies and characteristics of sexual dysfunction in women with stable relapsing-remitting multiple sclerosis (MS) and migraine.
Sexually active women aged 18-50 years were recruited at the MS and headache outpatient clinics of a university hospital and asked to complete questionnaires on sexual function using the multiple sclerosis intimacy and sexuality questionnaire (MSISQ-19) adapted for patients with migraine, depression using the Beck depression inventory (BDI-II) and quality of life using the short form-36 questionnaire (SF-36).
At least one symptom of sexual dysfunction was "almost always" or "always" present in 35.7 % of 42 patients with MS and in 22.6 % of 30 patients with migraine (p = 0.3). The MSISQ-19 total score did not differ between the two groups (31.6 ± 10.8 vs. 28.2 ± 11.6, respectively, p = 0.2). Sexual dysfunction was categorized as primary, secondary and tertiary in 66.7 %, 40 % and 33.3 % of MS patients and in 57.1 % (p = 0.7), 71.4 % (p = 0.2) and 71.4 % (p = 0.1) of migraine patients, respectively. Depressive symptoms were more common in women with sexual dysfunction than in those without both in MS (p = 0.001) and migraine (p = 0.006). The SF-36 showed decreasing quality of life with increasing MSISQ-19 sum scores (mental subscale p < 0.001 and physical subscale p = 0.04).
Sexual dysfunction is a major problem both in women with MS and in women with migraine and is strongly associated with comorbid depression and impaired quality of life. Thus, categorizing sexuality as done by MSISQ-19 is limited by its complex biopsychosocial interactions.
性是整体健康的一个组成部分，但神经疾病对性功能的影响仍然受到太少关注。
本病例对照研究的目的是比较稳定复发缓解型多发性硬化症（MS）和偏头痛女性性功能障碍的频率及特征。
在一所大学医院的MS和头痛门诊招募18至50岁的性活跃女性，要求她们使用为偏头痛患者改编的多发性硬化症亲密关系和性问卷（MSISQ - 19）、使用贝克抑郁量表（BDI - II）填写关于性功能的问卷以及使用简短健康调查量表（SF - 36）填写关于生活质量的问卷。
42例MS患者中有35.7%、30例偏头痛患者中有22.6%“几乎总是”或“总是”存在至少一种性功能障碍症状（p = 0.3）。两组的MSISQ - 19总分无差异（分别为31.6 ± 10.8和28.2 ± 11.6，p = 0.2）。MS患者中66.7%、40%和33.3%的性功能障碍分别被分类为原发性、继发性和第三发性，偏头痛患者中这一比例分别为57.1%（p = 0.7）、71.4%（p = 0.2）和71.4%（p = 0.1）。性功能障碍女性的抑郁症状在MS患者（p = 0.001）和偏头痛患者（p = 0.006）中均比无性功能障碍女性更常见。SF - 36显示随着MSISQ - 19总分增加生活质量下降（心理分量表p < 0.001，生理分量表p = 0.04）。
性功能障碍在MS女性和偏头痛女性中都是一个主要问题，并且与共病抑郁和生活质量受损密切相关。因此，如MSISQ - 19所做的那样对性进行分类受到其复杂的生物心理社会相互作用的限制。
