Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Reproductive Medicine Center, Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Mult Scler Relat Disord. 2023 Nov;79:105059. doi: 10.1016/j.msard.2023.105059. Epub 2023 Oct 9.
Multiple sclerosis (MS) is a chronic inflammatory and autoimmune neurodegenerative disease characterized by the destruction of myelin in the central nervous system, leading to significant health and quality of life burdens for patients. MS is most prevalent in younger individuals aged 20-40, a critical period when many patients hope to establish relationships and start families. While neurological disability, such as fatigue, sensory dysfunction, spasticity, and cognitive dysfunction, have been greatly improved with the advances in managing MS, physicians are frequently confronted with sexual and reproductive problems among younger male people with MS (PwMS). These issues mainly include erectile dysfunction, ejaculatory disorders, reduced libido, decreased sperm quality, and impaired male fertility. Despite recent studies indicating that MS negatively impacts the sexuality and fertility of male PwMS, these issues have not received sufficient attention. Genetic factors, autoimmunity, chronic inflammation, psychological factors, and the use of drugs may contribute to sexual/reproductive dysfunction in PwMS. However, like the overall understanding of MS pathophysiology, the complete mechanisms of its development remain unclear. In this study, we review the existing literature to summarize the range of sexual and reproductive issues unique to males with MS, explore potential underlying mechanisms, and aim to improve these issues in male PwMS. By shedding light on this overlooked aspect of MS, we hope to enhance the care and well-being of male PwMS facing these challenges.
多发性硬化症（MS）是一种慢性炎症性和自身免疫性神经退行性疾病，其特征是中枢神经系统髓鞘的破坏，导致患者健康和生活质量负担沉重。MS 最常见于 20-40 岁的年轻人，这是一个关键时期，许多患者希望建立关系并组建家庭。虽然神经功能障碍，如疲劳、感觉功能障碍、痉挛和认知功能障碍，已经随着 MS 管理的进步得到了极大的改善，但医生经常面临年轻男性多发性硬化症患者（PwMS）的性和生殖问题。这些问题主要包括勃起功能障碍、射精障碍、性欲降低、精子质量下降和男性生育能力受损。尽管最近的研究表明 MS 会对男性 PwMS 的性功能和生育能力产生负面影响，但这些问题尚未得到足够的重视。遗传因素、自身免疫、慢性炎症、心理因素和药物的使用都可能导致 PwMS 出现性功能/生殖功能障碍。然而，就像对 MS 病理生理学的整体理解一样，其发展的完整机制仍不清楚。在本研究中，我们回顾了现有文献，总结了 MS 男性特有的一系列性和生殖问题，探讨了潜在的潜在机制，并旨在改善男性 PwMS 中的这些问题。通过关注 MS 被忽视的方面，我们希望改善面临这些挑战的男性 PwMS 的护理和福祉。
