Sexual Dysfunction and Coping Strategies in Multiple Sclerosis Patients

Prevalence and risk of developing sexual dysfunction in women with multiple sclerosis (MS): a systematic review and meta-analysis

OBJECTIVE

To estimate the pooled prevalence of sexual dysfunction (SD) in women with multiple sclerosis (MS).

METHODS

We systematically searched PubMed, Scopus, EMBASE, Web of Science, and google scholar and also gray literature up to October 2021. The search strategy includes: ("Multiple Sclerosis" OR "MS" OR "Disseminated Sclerosis" OR (Disseminated AND Sclerosis) OR (Sclerosis AND Multiple)) AND ("Sexual Dysfunction" OR (Sexual AND Dysfunction) OR (Sexual AND Dysfunctions) OR (Sexual AND Disorders) OR (Sexual AND Disorder) OR "Sexual Dysfunctions" OR "Sexual Disorders" OR "Sexual Disorder" OR "Psychosexual Dysfunctions" OR (Dysfunction AND Psychosexual) OR (Dysfunctions AND Psychosexual) OR "Psychosexual Dysfunction" OR "Psychosexual Disorders" OR (Disorder AND Psychosexual) OR (Disorders AND Psychosexual) OR "Psychosexual Disorder" OR "Hypoactive Sexual Desire Disorder" OR "Sexual Aversion Disorder" OR (Aversion Disorders AND Sexual) OR (Disorders AND Sexual Aversion) OR "Sexual Aversion Disorders" OR "Orgasmic Disorder" OR (Disorders AND Orgasmic) OR "Orgasmic Disorders" OR "Sexual Arousal Disorder" OR (Arousal Disorders AND Sexual) OR (Disorders AND Sexual Arousal) OR "Sexual Arousal Disorders" OR "Frigidity").

RESULTS

We found 2150 articles by literature search, after deleting duplicates 1760 remained. Fifty-six articles remained for meta-analysis. The pooled prevalence of SD in MS patients estimated as 61% (95%CI:56-67%) (I²:95.7%, P < 0.001). The pooled prevalence of Anorgasmia in MS patients estimated as 29% (95%CI:20-39%) (I²:85.3%, P < 0.001). The pooled odds of developing SD in MS women estimated as 3.05(95%CI: 1.74-5.35) (I²:78.3%, P < 0.001). The pooled prevalence of decreased vaginal lubrication in MS patients estimated as 32%(95%CI:27-37%) (I² = 94.2%, P < 0.001). The pooled prevalence of reduced libido was 48%(95%CI:36-61%) (I²:92.6%, P < 0.001). The pooled prevalence of arousal problems was 40%(95%CI: 26-54%) (I²:97.4%, P < 0.001). The pooled prevalence of intercourse satisfaction was 27% (95%CI: 8-46%) (I²:99%, P < 0.001).

CONCLUSION

The result of this systematic review and meta-analysis show that the pooled prevalence of SD in women with MS is 61% and the odds of developing SD in comparison with controls is 3.05.

Systematic review of the prevalence, symptomatology and management options of sexual dysfunction in women with multiple sclerosis

AIMS

Sexual dysfunction (SD) is highly prevalent in women with multiple sclerosis (MS), however little is known about treatment options. The aim of this paper is to review the prevalence, symptomatology, and management options of sexual dysfunction in women with MS.

METHODS

The Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, PEDro, Database of International Rehabilitation Research, Occupational Therapy Systematic Evaluation of Evidence, ClinicalTrials.gov, and Current Controlled Trials databases were searched. No limitations were placed on the date. A critical appraisal of the literature on SD in women with MS was performed according to the PRISMA statement. Two reviewers screened and extracted data. Study quality was evaluated using a standardized tool.

RESULTS

A search of 12 databases identified 61 relevant studies (33 observational, 14 case-control, 4 follow up, 10 interventional). Significant variability in the prevalence of SD and questionnaires used to evaluate SD were observed. The most commonly reported sexual difficulties were problems with desire, arousal, and orgasm. Different demographics and MS-related characteristics were found to contribute to SD. Few studies have evaluated interventions for treating SD, and bias was high because of the weak quality of trial designs.

CONCLUSIONS

SD in women with MS is multidimensional, comparable in prevalence with other neurological disorders and increases with advancing disease. Studies evaluating practical strategies and pharmacological interventions are few, and properly designed trials using MS-specific validated outcome measures of SD are required to inform evidence-based treatment options for this high impact MS-related dysfunction.