Students' Research Group at the 1st Department of Obstetrics and Gynecology Medical University of Warsaw Warsaw Poland.
Department of Experimental and Clinical Physiology Medical University of Warsaw Warsaw Poland.
Brain Behav. 2017 Apr 14;7(6):e00699. doi: 10.1002/brb3.699. eCollection 2017 Jun.
Sexual dysfunction (SD) is one of the common symptoms of multiple sclerosis (MS) and is often underdiagnosed, especially in women. Relapsing-remitting multiple sclerosis (RRMS) is the most widespread form of the disease, but the data on SD occurrence in this particular group of patients is limited. The aim of the study was to analyze the associations between demographic factors, symptoms and signs of MS, psychiatric comorbidities and SD in female patients with RRMS.
MATERIAL & METHODS: A subgroup of 86 sexually active women with RRMS out of 218 total MS respondents was analyzed. Exclusion criteria included active relapse, EDSS score equal or higher than 6.5, and current pregnancy. All patients completed questionnaires including demographic data, questions about symptoms and signs of MS, Female Sexual Function Index (FSFI) for sexual performance, Patient Health Questionnaire 9 (PHQ-9) for depression, and Fatigue Severity Scale (FSS) for fatigue evaluation.
According to FSFI, SD occurred in 21 (27.27%) of the respondents. SD occurrence was associated with depression ( < .05) and speech disturbances ( < .04). A negative effect on sexual performance was associated with depression intensity ( < .003), fatigue intensity ( < .05), more advanced age at diagnosis ( < .02), lower education level ( < .05), and smaller area of residence ( < .002).
SD in women with RRMS is mostly associated with psychosocial parameters. Patients who are more depressed, presenting speech problems, less educated, and from smaller towns, should be considered high-risk for sexual dysfunction.
性功能障碍(SD)是多发性硬化症(MS)的常见症状之一,且常常漏诊,尤其是在女性中。复发缓解型多发性硬化症(RRMS)是最常见的疾病类型,但关于该特定患者群体中 SD 发生的数据有限。本研究旨在分析女性 RRMS 患者的人口统计学因素、MS 症状和体征、精神共病与 SD 之间的关联。
对 218 名 MS 患者中的 86 名活跃性女性患者进行了亚组分析。排除标准包括活动期复发、EDSS 评分等于或高于 6.5 分以及当前妊娠。所有患者均完成了调查问卷,包括人口统计学数据、MS 症状和体征问题、女性性功能指数(FSFI)以评估性行为表现、患者健康问卷 9 项(PHQ-9)以评估抑郁、疲劳严重程度量表(FSS)以评估疲劳。
根据 FSFI,21 名(27.27%)受访者出现 SD。SD 的发生与抑郁(<0.05)和言语障碍(<0.04)有关。抑郁严重程度(<0.003)、疲劳严重程度(<0.05)、诊断时年龄较大(<0.02)、教育水平较低(<0.05)、居住面积较小(<0.002)与性行为表现下降有关。
RRMS 女性中的 SD 主要与社会心理因素有关。那些更抑郁、有言语问题、受教育程度较低、居住在较小城镇的患者,应被视为性功能障碍的高危人群。