Physiological and psychological factors influencing sexual dysfunction in Multiple Sclerosis: Part 1

Abstract

Sexual dysfunction in Multiple Sclerosis (MS) commonly occurs but is often underreported. Erectile dysfunction is a symptom that frequently comes to medical evaluation but fatigue, problems in positioning, decreased sensation, and decreased libido add significantly to sexual dysfunction. Multiple Sclerosis (MS) is a central nervous system disease characterized by plaques of demyelination. It may affect as many as 60/100,000 in the Northern United States. It occurs between the ages of 20 and 40, but cases have been reported in patients over 50 as well. It affects females more often than males. Its etiology is unknown but a viral mechanism has been proposed. The course of the disease may be relapsing and remitting in nature or chronically progressive. Sexual dysfunction has been reported in MS. In some studies as high as 56% of women and 75% of men. Both physiologic and psychologic factors contribute to sexual dysfunction in persons with MS. Several symptoms have been cited as physiologic causes. For women, fatigue, and decreases in sensation, libido, frequency of orgasm and arousability have been cited. For men, erectile dysfunction is the most commonly mentioned symptom, but decreased sensation, fatigue, loss of libido and decreased orgasm have also been named. There is also evidence to believe that the problem of sexual dysfunction as a whole is underreported.⁴