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MS research update - Sex and MS: a study in men - 17 March 2014

Summary

It is known that MS can affect aspects of sexual function in both men and women. Such symptoms can be overlooked by health professionals. This study examined a group of men with MS, to see how common sexual dysfunction was and how this affected their sexual quality of life.

The researchers interviewed and assessed 67 men with MS. Just over half (53%) of the participants reported erectile dysfunction and just over a quarter (27%) had decreased sexual desire, however it was found only 1 in 17 (6%) had discussed their concerns with a health professional.

The authors recommend that health professionals should have more focus on sexual dysfunction, so men with MS can be offered appropriate advice and support.

Background

Sexual activity is an important part of life for many people and contributes to their quality of life, the quality of their relationships and to their self-esteem. It is known that MS can affect aspects of sexual function in both men and women. However it is also known that such sexual symptoms can often be overlooked by health professionals and people may be shy or embarrassed to mention it or do not think it could be related to their MS.

How this study was carried out

67 men with MS from Poland took part in the study. The aim was to see how common sexual dysfunction was and how this affected their sexual quality of life. The participants were interviewed, completed two questionnaires and underwent neurological examination. Participants Expanded Disability Status Scale (EDSS) score was also assessed, as a measure of the impact of their MS more generally.

The two questionnaires completed by the participants were the International Index of Erectile Function (IIEF) and the Sexual Quality of Life Questionnaire (SQoL).

The IIEF, contains 15 questions, covering erectile function, orgasmic function, sexual desire and intercourse satisfaction. Each question has five or six answers to choose from including never, sometimes and most times.

The SQoL, contains 11 questions, covering sexual confidence, emotional well-being and relationship issues. Each question has six response answers, ranging from "completely agree" to "completely disagree."

What was found

Just over half (53%) of the participants reported erectile dysfunction, just over a quarter (27%) had decreased sexual desire and difficulties in reaching orgasm (23%) or ejaculation (18%) were also common complaints.

The severity of sexual dysfunction had an impact on sexual quality of life, particularly in erectile dysfunction and intercourse satisfaction. The symptoms reported had no relation to age, time since MS onset or EDSS score, suggesting there were many factors involved.

The researchers found that although sexual dysfunction was common, only 1 in 17 (6%) participants had discussed their concerns with a medical professional.

What does it mean?

The researchers found that sexual dysfunction was common in men with MS and although it had a significant impact on their sexual quality of life, the majority had not discussed their concerns with a health professional.

The authors recommend that health professionals should have more focus on sexual dysfunction, so men with MS can be offered appropriate advice and support.

Lew-Starowicz M, Rola R.
Sexual dysfunctions and sexual quality of life in men with multiple sclerosis..
J Sex Med. 2014 Feb 24.[Epub ahead of print]
abstract

More about sex and MS

Both men and women with MS may have sexual issues, which can have a negative effect on their quality of life, but it is often a symptom that receives little attention. Many people can be reluctant to discuss them due to embarrassment and shyness.

Sexual difficulties can be experienced at any time during the course of MS. They may be the result of other MS symptoms including bladder symptoms, pain, fatigue or spasticity. They can also be a side effect of medication so it can be worth having this reviewed. Sometimes issues are minor and can be managed easily with general advice, at other times they can be more significant and require specialist input.

Not every sexual issue is due to MS and many of the difficulties described by people with MS also occur in the general population, for example anxiety, side effects of medication, other medical conditions and so on.

The MS Trust has two resources for people with MS and their partners. They can be read online, downloaded or ordered as books.

Sex and MS: a guide for men looks at how MS can affect the sex lives of men and how these issues can be managed. It includes suggestions on discussing sexual difficulties with partners and with health professionals as well as resources and organisations that may help.

Sexuality and MS: a guide for women explains how MS can impact on both sexuality and intimacy and offers positive and practical solutions. It is illustrated with comments, opinions, experiences and tips from women with MS.

Research by topic areas...

Symptoms and symptom management

Domingues RB, Carvalho TH, Vassallo DV, et al.
Altered cardiovascular reactivity to mental stress in patients with multiple sclerosis.
Neurol Sci. 2014 Mar 13. [Epub ahead of print]
abstract

Bakalidou D, Giannopoulos S, Stamboulis E, et al.
Effect of seasonal fluctuation of ambient temperature on fatigue in multiple sclerosis patients living in Attica, Greece.
J Clin Neurosci. 2013 Dec 19. [Epub ahead of print]
abstract

Bruno E, Nicoletti A, Messina S, et al.
Restless legs syndrome and multiple sclerosis: a population based case-control study in Catania, Sicily.
Eur J Neurol. 2014 Mar 12. [Epub ahead of print]
abstract

Kratz AL, Ehde DM, Bombardier CH.
Affective mediators of a physical activity intervention for depression in multiple sclerosis.
Rehabil Psychol. 2014 Feb;59(1):57-67.
abstract

Preziosi G, Raptis DA, Raeburn A, et al.
Autonomic rectal dysfunction in patients with multiple sclerosis and bowel symptoms is secondary to spinal cord disease.
Dis Colon Rectum. 2014 Apr;57(4):514-21.
abstract

Disease modifying treatments

Burness CB, Deeks ED.
Dimethyl Fumarate: A review of its use in patients with relapsing-remitting multiple sclerosis.
CNS Drugs. 2014 Mar 13. [Epub ahead of print]
abstract

Río J, Rovira A, Tintoré M, et al.
Evaluating the response to glatiramer acetate in relapsing-remitting multiple sclerosis (RRMS) patients.
Mult Scler. 2014 Mar 12. [Epub ahead of print]
abstract

Landy DC, Hecht EM.
Benefit of additional screening for progressive multifocal leukoencephalopathy in patients with multiple sclerosis taking natalizumab: A decision analysis.
Clin Neuropharmacol. 2014 Mar 7. [Epub ahead of print]
abstract

Giovannoni G, Naismith RT.
Natalizumab to fingolimod washout in patients at risk of PML: When good intentions yield bad outcomes.
Neurology. 2014 Mar 7. [Epub ahead of print]
abstract

Jokubaitis VG, Li V, Kalincik T, et al.
Fingolimod after natalizumab and the risk of short-term relapse.
Neurology. 2014 Mar 7. [Epub ahead of print]
abstract

Link J, Lundkvist Ryner M, Fink K, et al.
Human leukocyte antigen genes and interferon Beta preparations influence risk of developing neutralizing anti-drug antibodies in multiple sclerosis.
PLoS One. 2014 Mar 7;9(3)
abstract
Read the full text of this paper

Other treatments

Jawahar R, Oh U, Yang S, et al.
Alternative approaches: A systematic review of non-pharmacological treatments for non-spastic and non-trigeminal pain in patients with multiple sclerosis.
Eur J Phys Rehabil Med. 2014 Mar 4. [Epub ahead of print]
abstract

Sanoobar M, Eghtesadi S, Azimi A, et al.
Coenzyme Q10 supplementation ameliorates inflammatory markers in patients with multiple sclerosis: a double blind, placebo, controlled randomized clinical trial.
Nutr Neurosci. 2014 Jan 10. [Epub ahead of print]
abstract

Assessment tools

Mishra C, Ganesh GS.
Inter-rater reliability of modified modified Ashworth Scale in the assessment of plantar flexor muscle spasticity in patients with spinal cord injury.
Physiother Res Int. 2014 Mar 12. [Epub ahead of print]
abstract

Larson RD, Larson DJ, Baumgartner TB, et al.
Repeatability of the timed 25-foot walk test for individuals with multiple sclerosis.
Clin Rehabil. 2013 Aug;27(8):719-23.
abstract

Causes of MS

Nielsen NM, Bager P, Simonsen J, et al.
Major stressful life events in adulthood and risk of multiple sclerosis.
J Neurol Neurosurg Psychiatry. 2014 Mar 7. [Epub ahead of print]
abstract

Paediatric MS

Meyer P, Leboucq N, Molinari N, et al.
Partial acute transverse myelitis is a predictor of multiple sclerosis in children.
Mult Scler. 2014 Mar 11. [Epub ahead of print]
abstract

Physical activity

Hansen D, Feys P, Wens I, et al.
Is walking capacity in subjects with multiple sclerosis primarily related to muscle oxidative capacity or maximal muscle strength? A pilot study.
Mult Scler Int. 2014
abstract
Read the full text of this paper

Anens E, Emtner M, Zetterberg L, et al.
Physical activity in subjects with multiple sclerosis with focus on gender differences: a survey.
BMC Neurol. 2014 Mar 10;14(1):47.
abstract
Read the full text of this paper

Beier M, Bombardier CH, Hartoonian N, et al.
Improved physical fitness correlates with improved cognition in multiple sclerosis.
Arch Phys Med Rehabil. 2014 Mar 4. [Epub ahead of print]
abstract

Nogueira LA, Teixeira L, Sabino P, et al.
Gait characteristics of multiple sclerosis patients in the absence of clinical disability.
Disabil Rehabil. 2013 Aug;35(17):1472-8.
abstract

Prognosis

Wu X, Hanson LG, Skimminge A, et al.
Cortical N-acetyl aspartate is a predictor of long-term clinical disability in multiple sclerosis.
Neurol Res. 2014 [Epub ahead of print]
abstract

Pregnancy and childbirth

Beaber BE, Chi MD, Brara SM, et al.
Immunomodulatory agents and risk of postpartum multiple sclerosis relapses.
Perm J. 2014 Winter;18(1):9-13.
abstract

Work

Kirk-Brown A, Van Dijk P.
An empowerment model of workplace support following disclosure, for people with MS.
Mult Scler. 2014 Mar 11. [Epub ahead of print]
abstract

Services

Political notebook.
Nurs Stand. 2014 Mar 12;28(28):12.
abstract

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