Multiple sclerosis patients with and without sexual dysfunction: are there any differences?

2006 ◽  
Vol 12 (2) ◽  
pp. 209-211 ◽  
Author(s):  
M. Demirkiran ◽  
Y. Sarica ◽  
S. Uguz ◽  
D. Yerdelen ◽  
K. Aslan

Objective Sexual dysfunction (SD) severely affects the quality of life in patients with multiple sclerosis (MS). The aim of this study is to investigate the type and frequency of sexual complaints in MS patients, to analyse their relationship to various clinical and psychosocial variables and to clarify the differences between MS patients with and without SD. Methods Thirty-five relapsing-remitting (RR), nine secondary progressive and seven primary progressive MS patients were included in this study. A structured face-to-face interview regarding sexual function and other physical problems which may interfere with sexual functioning was administered to each patient. They also filled out Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), which includes items for primary (direct physical), secondary (indirect physical) and tertiary (psychosocial) causes of SD. Disability, cognitive functions and psychological functioning were also evaluated. Results Forty-one patients (80.4%) reported primary SD; decreased libido was the most frequent complaint (80.5%). These patients were older and more disabled, however 39% had low disability scores. SD was a common problem for both men and women. Patients with RRMS were affected less in all items of primary SD. Several items of secondary SD-problems with memory and concentration, bladder symptoms, bowel symptoms-showed correlation with different items of primary SD; these were altered genital sensation, decreased libido, increased time for arousal, decreased lubrication/difficulties with erection. Total MSISQ-19 scores were correlated with disease duration, age, disability, disease course, Beck depression scale, temporary and long-standing anxiety and low level of education. Conclusion SD is an underestimated, common symptom of MS. It may occur in MS even in the absence of severe disability. Physicians’ awareness of this problem may help to bring about appropriate treatments and management, and improve the quality of life for these patients.

2021 ◽  
Vol 12 ◽  
Author(s):  
Patrick Altmann ◽  
Fritz Leutmezer ◽  
Katharina Leithner ◽  
Tobias Monschein ◽  
Markus Ponleitner ◽  
...  

Sexual dysfunction (SD) in people with multiple sclerosis (pwMS) has a detrimental impact on individual health-related quality of life (HRQoL). It is not clear whether SD in multiple sclerosis (MS) is an independent symptom or merely a byproduct of other symptoms such as depression or anxiety. This cross-sectional study of 93 pwMS determines risk factors for SD in MS based on prevalence, HRQoL, and associated disease outcomes. Diagnosis of SD was determined based on the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) and correlated with physical disability (measured by Expanded Disability Status scale, EDSS), depression and anxiety [Hospital Anxiety and Depression Scale (HADS)], and HRQoL [Multiple Sclerosis Quality of Life-54 (MSQoL-54)]. Multivariate regression models were performed to determine independent risk factors for SD in pwMS. Almost half of the participants in this study (46%) reported SD. HRQoL was significantly poorer in patients with MS suffering from SD (median [IQR] MSQoL-54 scores: physical subscale 52 [41–68] vs. 81 [69–89], p < 0.001; mental subscale 50 [38–82] vs. 86 [70–89], p < 0.001). In the multivariate model, EDSS was the only independent risk factor for SD (OR 18.1 for EDSS ≥4 [95% CI 3.3–31.4, p < 0.001]), while depression and anxiety were not. We conclude that the risk for SD is growing with increasing EDSS and is independent of depression or anxiety. Screening for SD becomes particularly relevant in patients with growing disability.


2020 ◽  
pp. 33-37
Author(s):  
O.I. Nehrych ◽  
◽  
V.I. Pyrohova ◽  

Despite a lot of studies of sexual dysfunction there are still no consistent data about the prevalence and characteristics of sexual dysfunction among women with MS, especially it terms of multiple sclerosis severity and duration. The objective: was to determine the prevalence of various SD symptoms among female MS patients, depending on the age and severity of the disease, and evaluate SD impact on quality of life. Materials and methods. The study population includes 116 female patients with MS (McDonald’s criteria, 2010). Health – related quality of life was measured by the Multiple Sclerosis Quality of Life Questionnaire (MSQOL-54). Sexual dysfunction was assessed with the Sexual Function Index for Women with Multiple Sclerosis Questionnaire. Results. A direct average correlation between satisfaction with sexual life and relationships; sexual activity and arousal; discomfort and pain during sexual intercourse; direct impact of multiple sclerosis on sexual life and total quality of life, physical health component, mental health component was established (р<0.05). The prevalence of sexual dysfunction increases with the age and disease duration. Conclusions. Our data confirm that SD is common symptom in women with MS and significantly affect their quality of life. Key words: multiple sclerosis, female sexual dysfunction.


2013 ◽  
Vol 36 (12) ◽  
pp. 987-992 ◽  
Author(s):  
Marianna Vitkova ◽  
Jaroslav Rosenberger ◽  
Martina Krokavcova ◽  
Jarmila Szilasiova ◽  
Zuzana Gdovinova ◽  
...  

PM&R ◽  
2009 ◽  
Vol 1 ◽  
pp. S191-S192
Author(s):  
Paolo Di Benedetto ◽  
Emanuele Biasutti ◽  
Dario Marin ◽  
Luisa Monti Bragadin

Biomolecules ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 393
Author(s):  
Oliver Neuhaus ◽  
Wolfgang Köhler ◽  
Florian Then Bergh ◽  
Wolfgang Kristoferitsch ◽  
Jürgen Faiss ◽  
...  

Although fatigue is a common symptom in multiple sclerosis (MS), its pathomechanisms are incompletely understood. Glatiramer acetate (GA), an immunomodulatory agent approved for treatment of relapsing-remitting MS (RRMS), possesses unique mechanisms of action and has been shown to exhibit beneficial effects on MS fatigue. The objective of this study was to correlate clinical, neuropsychological, and immunological parameters in RRMS patients with fatigue before and during treatment with GA. In a prospective, open-label, multicenter trial, 30 patients with RRMS and fatigue were treated with GA for 12 months. Inclusion criterion was the presence of fatigue as one of the most frequent and disabling symptoms. Before and during treatment, fatigue was assessed using the Fatigue Severity Scale (FSS), the MS-FSS, and the Modified Fatigue Impact Scale (MFIS). In addition, fatigue and quality of life were assessed using the Visual Analog Scales (VAS). Laboratory assessments included screening of 188 parameters using real-time PCR microarrays followed by further analysis of several cytokines, chemokines, and neurotrophic factors. Fatigue self-assessments were completed in 25 patients. After 12 months of treatment with GA, 13 of these patients improved in all three scales (with the most prominent effects on the MFIS), whereas 5 patients had deteriorated. The remaining 7 patients exhibited inconsistent effects within the three scales. Fatigue and overall quality of life had improved, as assessed via VAS. Laboratory assessments revealed heterogeneous mRNA levels of cytokines, chemokines, and neurotrophic factors. In conclusion, we were not able to correlate clinical and molecular effects of GA in patients with RRMS and fatigue.


2002 ◽  
Vol 8 (6) ◽  
pp. 527-531 ◽  
Author(s):  
C-H Chang ◽  
D Cella ◽  
O Fernández ◽  
G Luque ◽  
P de Castro ◽  
...  

Objective: The cross-sectional study evaluated the psychometric properties of the Functional Assessment of Multiple Sclerosis (FAMS) Spanish version and its use in measuring quality of life (QOL) of multiple sclerosis (MS) patients in Spain. Methods: The FAMS is a factorially derived self-report scale designed to assess six primary aspects of QOL of patients with MS: Mobility, Symptoms, Emotional Well-Being, General Contentment, Thinking and Fatigue, and Family/Social Well-Being. Its Spanish translated version was used to assess QOL of 625 MS patients recruited in an outpatient clinic setting from 58 hospitals in Spain. Internal consistency of the Spanish FAMS was evaluated. Multiple regression analyses were performed to identify significant predictors from demographic, clinical and treatment characteristics, and Kurtzke Expanded Disability Status Scale (EDSS) scores in predicting FAMS scale scores. Results: Most of the patients are females (66%), and 74% were of the relapsing-remitting (RR) clinical subtype. Cronbach’s alpha coefficients were high (range=0.78-0.96), indicating subscale homogeneity comparable to that of the original English version. Linear multivariate regression analyses revealed that the EDSS is a dominant variable in predicting all the FAMS subscales, especially mobility (R2=0.51) and the total scores. Conclusions: The Spanish FAMS is a psychometrically valid instrument that allows clinicians and clinical researchers the ability to measure the QOL concerns of MS patients in Spain.


2010 ◽  
Vol 16 (4) ◽  
pp. 480-490 ◽  
Author(s):  
U. Dalgas ◽  
E. Stenager ◽  
J. Jakobsen ◽  
T. Petersen ◽  
HJ Hansen ◽  
...  

Fatigue occurs in the majority of multiple sclerosis patients and therapeutic possibilities are few. Fatigue, mood and quality of life were studied in patients with multiple sclerosis following progressive resistance training leading to improvement of muscular strength and functional capacity. Fatigue (Fatigue Severity Scale, FSS), mood (Major Depression Inventory, MDI) and quality of life (physical and mental component scores, PCS and MCS, of SF36) were scored at start, end and follow-up of a randomized controlled clinical trial of 12 weeks of progressive resistance training in moderately disabled (Expanded Disability Status Scale, EDSS: 3—5.5) multiple sclerosis patients including a Control group ( n = 15) and an Exercise group ( n = 16). Fatigue (FSS > 4) was present in all patients. Scores of FSS, MDI, PCS—SF36 and MCS—SF36 were comparable at start of study in the two groups. Fatigue improved during exercise by —0.6 (95% confidence interval (CI) —1.4 to 0.4) a.u. vs. 0.1 (95% CI —0.4 to 0.6) a.u. in controls ( p = 0.04), mood improved by —2.4 (95% CI —4.1 to 0.7) a.u. vs. 1.1 (—1.2 to 3.4) a.u. in controls ( p = 0.01) and quality of life (PCS—SF36) improved by 3.5 (95% CI 1.4—5.7) a.u. vs. —1.0 (95% CI —3.4—1.4) a.u. in controls ( p = 0.01). The beneficial effect of progressive resistance training on all scores was maintained at follow-up after further 12 weeks. Fatigue, mood and quality of life all improved following progressive resistance training, the beneficial effect being maintained for at least 12 weeks after end of intervention.


2008 ◽  
Vol 14 (8) ◽  
pp. 1131-1136 ◽  
Author(s):  
DK Tepavcevic ◽  
J Kostic ◽  
ID Basuroski ◽  
N Stojsavljevic ◽  
T Pekmezovic ◽  
...  

Objective Sexual dysfunction (SD) is a common but often overlooked symptom in multiple sclerosis (MS). The aim of this study was to estimate the frequency, type, and intensity of SD in our patients with MS and to investigate its influence on all the domains of quality of life. Methods The study population comprised a cohort of 109 patients with MS (McDonald's criteria, 2001). SD was quantified by a Szasz sexual functioning scale. Health-related quality of life was measured by a disease-specific instrument MSQoL-54 (Serbian version). Results The presence of at least one symptom of SD was found in about 84% of the men and in 85% of the women. The main complaints in women were reduced libido, difficulties in achieving orgasm, and decreased vaginal lubrication; in men, the main complaints were reduced libido, incomplete erections, and premature ejaculation. In women, statistically significant negative correlations between the presence and level of SD and quality of life domains were reached for all subscales ( P < 0.01), except for the Pain subscale ( P = 0.112). In men, negative correlations were also observed for all domains, but they were statistically significant for physical health, physical role limitations, social function, health distress, sexual function, and sexual function satisfaction ( P < 0.01). We found that the presence of all the analyzed types of sexual problems statistically significantly lowered scores on the sexual function and the sexual function satisfaction subscales in both men and women ( P < 0.01). The most prominent impact on both domains was observed for the total loss of erection in men and for anorgasmia in women. Conclusions Our results reveal that frequent occurrence of SD in MS patients prominently affects all aspects of their quality of life.


2006 ◽  
Vol 12 (4) ◽  
pp. 428-436 ◽  
Author(s):  
H Hildebrandt ◽  
H K Hahn ◽  
J A Kraus ◽  
A Schulte-Herbrüggen ◽  
B Schwarze ◽  
...  

Objective To assess whole brain and central brain atrophy as well as their differential relation to memory, cognitive performance, fatigue, depression and quality of life in patients with relapsingremitting multiple sclerosis (RRMS). Methods A 3D flow compensated gradient recalled T1-weighted MRI was acquired in 45 RRMS patients. An automated analysis tool was used to calculate brain parenchymal fraction (BPF) and ventricular brain fraction (VF). All patients were assessed with neuropsychological tests focusing on memory and self-rating scales for depression, fatigue and quality of life. Age corrected partial correlations between brain atrophy, motor performance, psychological scales and test scores were calculated. Results BPF correlated moderately (0.35≤r<0.5) with duration of symptoms and disease, the Expanded Disability Status Scale (EDSS), the upper extremity motor performance, and with mental aspects of quality of life. VF correlated moderately with EDSS, upper and lower extremity motor performance and memory functions. Neither BPF nor VF correlated with fatigue and depression. Results of several cognitive tests correlated moderately with depression and fatigue, the Paced Auditory Serial Addition Test (PASAT) showing the largest correlation. Conclusions Memory performance shows a correlation with relative ventricular size in RRMS patients, indicating the strategic location of the ventricle system along the structures of the limbic system and its vulnerability in MS. The PASAT and several other cognitive tests show moderate correlations with depression and fatigue, arguing for an inter relation between the cognitive functioning and the emotional state of patients. However, this relation is independent of measurable brain atrophy.


2018 ◽  
Vol 25 (6) ◽  
pp. 856-866 ◽  
Author(s):  
Rosalba Rosato ◽  
Silvia Testa ◽  
Antonio Bertolotto ◽  
Francesco Scavelli ◽  
Ambra M Giovannetti ◽  
...  

Background: We recently devised a shortened version of the 54-item Multiple Sclerosis Quality of Life (MSQOL-54) in paper (MSQOL-29, consisting of 25 items forming 7 subscales and 4 single items, and one filter question for 3 ‘sexual function’ items) and electronic format (eMSQOL-29). Objectives: To prospectively assess eMSQOL-29 psychometric properties, acceptability/equivalence versus MSQOL-29. Methods: Multiple sclerosis (MS) patients ( n = 623; Expanded Disability Status Scale (EDSS) range 0.0–9.0) completed eMSQOL-29, Hospital Anxiety and Depression Scale, Functional Assessment of MS (FAMS), European Quality of life Five Dimensions-3L, and received EDSS and Symbol Digit Modalities Test (SDMT). Equivalence versus MSQOL-29 was assessed in 242 patients (randomized cross-over design). Results: ‘Sexual function’ items were filtered out by 273 patients (47%). No multi-item scale had floor effect, while five had ceiling effect. Cronbach’s alpha range was 0.88–0.90. Confirmatory factor analysis showed good overall fit and the two-factor solution for composite scores was confirmed. Criterion validity was sub-optimal for ‘cognitive function’ (vs SDMT, r = 0.25) and ‘social function’ (vs FAMS social function, r = 0.38). eMSQOL-29 equivalence was confirmed and its acceptability was good. Conclusion: eMSQOL-29 showed good internal consistency, factor structure and no floor effect, while most subscales had some ceiling effect. Criterion validity was sub-optimal for two subscales. Equivalence and acceptability were good.


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