Sexual Dysfunction in Female Patients With Multiple Sclerosis: Relationship With Functional Status, Fatigue, Depression, Sleep Quality, and Quality of Life

Abstract

Background Although sexual dysfunction is one of the most common symptoms in patients with multiple sclerosis (MS), there are relatively few studies on this topic. Aim The aim of this study was to assess sexual function in female MS patients and investigate its association with functional state, fatigue, depression, sleep, and quality of life. Methods This descriptive cross-sectional study was conducted between May and November 2019 with MS patients attending an MS outpatient clinic at a university hospital. Patients' sexual function was assessed using the Female Sexual Function Index (FSFI). Expanded Disability Status Scale (EDSS), Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and Multiple Sclerosis Quality of Life Scale (MSQoL-54) were used to determine their relationship to sexual function. Outcomes Sexual function, functional status, depression, sleep quality, and quality of life. Results The mean age of the 83 patients included in the study was 41.8 (+/- 8.5) years, and all were married. The mean FSFI score of the patients was 21.1 (+/- 8.9) and 26.55, 72.3% of patients were found to have sexual dysfunction. FSFI scores were found to have a negative correlation with age (r = -0.398, P = .001), duration of diagnosis (r = -0.338, P = .001), and EDSS scores (r = -0.326, P = 0.040). Patients taking symptomatic medication (P = .032) and antidepressants (P = .012) had lower mean FSFI scores. Additionally, the FSFI score showed a significant negative correlation with the FSS (r = -0.368, P = .001), the BDI (r = -0.423, P < .001), the PSQI (r = -0.314, P = .004), and the MSQoL-54 (physical health: r = 0.509, P < .001 and mental health: r = 0.431, P < .001). Clinical implications A comprehensive evaluation of sexual dysfunction and the development of tailored treatment plans, taking into account associated factors, will be beneficial for female patients with MS. Strengths and Limitations Small sample size and assessment of sexual function by a generic scale are the limitations of this study. Conclusion Considering the multifactorial nature of sexual dysfunction in female MS patients, it is recommended that patients be assessed multidimensionally during outpatient follow-up visits.