Gynecology and Physiopathology of Human Reproduction, S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
Gynecology and Physiopathology of Human Reproduction, S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
J Sex Med. 2019 Jun;16(6):833-842. doi: 10.1016/j.jsxm.2019.03.011. Epub 2019 Apr 19.
Sexual dysfunction (SD) is common but still underdiagnosed in women with multiple sclerosis (MS); in fact, the lack of a consistent use of validated diagnostic tools makes the prevalence of SD and related distress difficult to define precisely.
To assess the prevalence of SD in Italian women with MS compared with age-matched healthy control subjects (HC) and the association with demographic, psychological, and MS-related characteristics.
The Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale were administered to 153 women with MS and 153 HC. Demographic, gynecologic, and neurologic data were obtained. Disability was assessed using the Expanded Disability Status Scale. Psychological symptoms were evaluated in MS patients with Profile of Mood State and the Beck Depression Inventory II.
Prevalence of SD and sexual distress in women with MS compared with HC.
Among women sexually active in the last month, we found an increased prevalence of SD in MS patients compared with HC subjects (42.0% vs 16.0%, P = .0001). The prevalence of dysfunctional FSFI global scores (<26.55) was higher in women with MS compared with HC (49.6% vs 33.6%, P = .014). In the MS group, the prevalence of SD was similar between pre- and post-menopausal women. Both premenopausal and postmenopausal MS women presented a greater prevalence of SD if compared with the premenopausal and postmenopausal HC groups (30/79 [37.9%] vs. 5/74 [6.8%], P = .0001 and 20/40 [50.0%] vs 16/57 [28.1%], P = .03, respectively). A negative correlation was observed between the FSFI global score and age and Expanded Disability Status Scale. Depressive symptoms were more common in women with MS and SD than in those without.
This study suggests that sexual function investigation should always be a standard part of the consultation with healthcare professionals for MS.
STRENGTH & LIMITATIONS: The strength of this study was the comparison with an age-matched healthy control group and the use of validated questionnaires to assess both sexual function and sexual distress. Larger and multicenter studies may further support our findings.
In our cohort, the prevalence of SD and sexual distress was higher in women with MS compared to the HC group. Age, disability, and depressive symptoms were associated with increased SD. Gava G, Visconti M, Salvi F, et al. Prevalence and Psychopathological Determinants of Sexual Dysfunction and Related Distress in Women With and Without Multiple Sclerosis. J Sex Med 2019;16:833-842.
性障碍（SD）在多发性硬化症（MS）女性中很常见，但仍未得到充分诊断；事实上，由于缺乏一致使用经过验证的诊断工具，SD 的患病率和相关痛苦的定义难以准确确定。
评估意大利 MS 女性与年龄匹配的健康对照组（HC）相比 SD 的患病率，并评估其与人口统计学、心理和 MS 相关特征的关系。
对 153 名 MS 女性和 153 名 HC 进行女性性功能指数（FSFI）和女性性困扰量表评估。获取人口统计学、妇科和神经学数据。使用扩展残疾状态量表评估残疾情况。在 MS 患者中使用心境状态问卷和贝克抑郁量表 II 评估心理症状。
MS 女性 SD 和性困扰的患病率与 HC 相比。
在过去一个月有性生活的女性中，我们发现 MS 患者的 SD 患病率高于 HC 组（42.0%比 16.0%，P =.0001）。与 HC 相比，MS 患者的 FSFI 全球评分（<26.55）功能障碍发生率更高（49.6%比 33.6%，P =.014）。在 MS 组中，绝经前和绝经后女性的 SD 患病率相似。与绝经前和绝经后 HC 组相比，无论绝经前还是绝经后 MS 女性的 SD 患病率均更高（30/79 [37.9%]比 5/74 [6.8%]，P =.0001 和 20/40 [50.0%]比 16/57 [28.1%]，P =.03）。FSFI 全球评分与年龄和扩展残疾状态量表呈负相关。MS 女性和 SD 女性的抑郁症状比无 MS 女性和 SD 女性更为常见。
本研究表明，性功能调查应始终成为 MS 患者与医疗保健专业人员咨询的标准部分。
本研究的优势在于与年龄匹配的健康对照组进行比较，并使用经过验证的问卷评估性功能和性困扰。更大规模和多中心的研究可能会进一步支持我们的发现。
在我们的队列中，与 HC 组相比，MS 女性的 SD 和性困扰的患病率更高。年龄、残疾和抑郁症状与 SD 增加相关。
