Department of Nursing, University of Alicante, Alacant, Spain.
Clin Rehabil. 2020 Apr;34(4):438-449. doi: 10.1177/0269215520901751. Epub 2020 Feb 12.
To evaluate the effectiveness of interventions aimed at improving the sexuality of women with multiple sclerosis.
MEDLINE, CINAHL, PsycINFO, Web of Science, Scopus, Embase and the Cochrane Library, as well as doctoral thesis databases Teseo and ProQuest Dissertations & Theses Global and the grey literature database Opengrey were searched, last on 15 October 2019. Journals related to the topic were also consulted. The bibliographic references of the articles included were reviewed.
Studies were selected if they included women with multiple sclerosis in whom interventions aimed at reducing sexual dysfunction were applied. Data extraction was carried out by two independent reviewers. The Jadad scale was used to evaluate the methodological quality of the studies included.
In total, 12 clinical trials were selected, and 611 patients were examined. Studies were classified into six interventions: sexual therapy (4), pharmaceutical drugs (3), pelvic floor exercises (2), yoga (1), mindfulness (1) and vaginal devices (1). Most of them improved some primary outcomes of sexual dysfunction such as lubrication, arousal, desire or orgasm. Pain was the most common secondary outcome evaluated and it became better in two studies including sexual therapy and in one intervention with pelvic floor exercises. Tertiary outcomes such as anxiety or depression were rarely examined, and they improved with sexual therapy and with OnabotulinumtoxinA.
Sexual therapy, administration of OnabotulinumtoxinA, pelvic floor muscles exercises alone or combined with electrostimulation and the use of clitoral devices could be the most recommended interventions to improve the sexuality in women with multiple sclerosis.
评估旨在改善多发性硬化症女性性功能的干预措施的有效性。
MEDLINE、CINAHL、PsycINFO、Web of Science、Scopus、Embase 和 Cochrane 图书馆，以及博士论文数据库 Teseo 和 ProQuest Dissertations & Theses Global 和灰色文献数据库 Opengrey，最后检索日期为 2019 年 10 月 15 日。还查阅了与该主题相关的期刊。对纳入文章的参考文献进行了审查。
如果研究中包含旨在减少性功能障碍的干预措施，则选择纳入女性多发性硬化症患者。由两名独立评审员进行数据提取。使用 Jadad 量表评估纳入研究的方法学质量。
共选择了 12 项临床试验，共检查了 611 名患者。研究分为 6 种干预措施：性治疗（4 项）、药物（3 项）、骨盆底运动（2 项）、瑜伽（1 项）、正念（1 项）和阴道器械（1 项）。大多数研究改善了性功能障碍的一些主要结局，如润滑、唤起、欲望或高潮。评估的最常见次要结局是疼痛，性治疗和骨盆底运动锻炼各有两项研究显示疼痛有所改善。很少检查焦虑或抑郁等三级结局，性治疗和 OnabotulinumtoxinA 治疗后这些结局有所改善。
性治疗、OnabotulinumtoxinA 给药、单独或联合电刺激的骨盆底肌肉锻炼以及使用阴蒂刺激器可能是改善多发性硬化症女性性功能最推荐的干预措施。
