What are the barriers faced in discussing Multiple sclerosis-related sexual dysfunction during clinic? (original) (raw)
Related papers
A practical approach to assessing and managing sexual dysfunction in multiple sclerosis
Practical Neurology, 2019
Sexual dysfunction is common in both men and women with multiple sclerosis but is often under-reported and undertreated. Neurologists report that a major barrier to discussing sexual dysfunction with patients is their lack of knowledge. Here we review the common presentations of sexual dysfunction, discuss its causes in people with multiple sclerosis, and provide a practical approach for neurologists to assess and manage these problems.
Sexual dysfunction in men with multiple sclerosis — A comprehensive pilot-study into etiology
International Journal of Impotence Research, 1999
Ideally, the etiological diagnosis of sexual dysfunction in patients with multiple sclerosis is established on the basis of both objective and subjective tests. Accordingly, we assessed sexual function in 16 male patients with multiple sclerosis and complaints of sexual dysfunction by means of subjective data from interviews and questionnaires and objective data, obtained from (psycho)physiological tests. Psychophysiological investigation consisted of measurement of sleep erections and of erectile response to visual erotic stimulation and penile vibration. Urodynamic investigation was used to assess the neurological status of the genital tract. Sixteen male patients with clinically de®nite multiple sclerosis, complaints of sexual dysfunction and a steady heterosexual relationship participated in the study. The majority of patients had no abnormalities in the objective tests. Only one (1 out of 15) patient showed disturbed sleep-erections, and four (4 out of 12) other patients showed signs of neurological dysfunction of the genital tract. Conclusion: in our patient-group, disturbed sleep erections and abnormal ®ndings on urodynamic investigation appeared unrelated to the complaint of erectile dysfunction. Sexual function was related to psychological factors, decreased general sensitivity, and motor impairment.
Correlates of Sexual Dysfunction in Men and Women with Multiple Sclerosis
Journal of Neuroscience Nursing, 2008
Sexual dysfunction (SD) is an often overlooked disability in multiple sclerosis (MS). The pur- pose of this study was to investigate the relationship between SD and other disabilities in men and women with MS. The sample included 32 men and 219 women. The men ranged in age from 32 to 65 years with a mean of 47.6 years. The women
Sexual Dysfunctions in Multiple Sclerosis
Annals of the New York Academy of Sciences, 1984
The frequency, nature and enjoyment of sexual practices may be disturbed by acute or chronic illness. Sexual problems may be caused by, among other factors, the nonspecific symptoms of illness, the anxieties over disruption of lifestyle or the specific impairments caused by a disorder. Patients with, for example, multiple sclerosis are thought to experience sexual problems commonly. In one study, Lilius found that in a group of 284 MS patients, 64% of the men and 39% of the women described their sexual life as "unsatisfactory" or "ceased entirely."' Lundberg found that 90% of his MS patients confined to wheelchairs "have major problems with sexual function."* Szasz et al. used a Sexual Functioning Scale to study 73 consecutive patients a t an M S clinic and found that 45% of the patients were "less sexually active" or "inactive" since the onset of MS. Fifty percent of this group indicated that they were "concerned" about this situation.' In a follow-up study, 18 "concerned" MS patients listed their sexual concerns as: "cannot satisfy the partner" (1 1 patients), "don't feel like sex" (9 patients), "cannot satisfy myself" (1 1 patients), "cannot be like a man" (4 patients), and "partner does not feel like sex" (2 patients). Fifteen of these patients were men; most were over the age of 40, and most were married. The three women were over the age of 50. and only one was married. Most of these patients had M S for over 10 years. Their rating on the Kurtzke Disability Scale ranged from 1 to 7.4 The purpose of this paper is to consider the epidemiology, diagnosis and management of one sexual problem area that may be associated with MS, that of sexual dysfunctions. CLASSIFICATION Sexual dysfunctions include erectile and ejaculatory disorders in men, disorders of vaginal lubrication, orgasm and vaginismus in women. Some definitions also include sexual disinterest.' The nature and the significance of these dysfunctions vary and are dependent on a variety of factors, including the health and the age of the patient and the presence or absence of a partner. EPIDEMIOLOGY Sexual Dysfunctions in the General Population Kinsey et al. estimated that impotence affected 18% of the American male population at the age of 60. Premature ejaculation was not considered a disorder and 9% of women were described as nonorgasmic on a lifetime basis! Frank et al. studied 100 white well-educated couples who were nonpatient volunteers. Forty percent of the men reported erectile or ejaculatory problems. Sixty-three percent of the women described orgasmic dysfunctions. However, 80% of
Sexual dysfunction in women with multiple sclerosis: Dimensions and contributory factors
Journal of Research in Medical Sciences, 2014
Sexual dysfunction (SD) is a common reported problem in patients with multiple sclerosis (MS). to examine frequency and distribution of SD dimensions and to determine whether SD is related to various clinical and demographic variables in female patients. A total of 271 MS women (age: 19-50 years) participated in this cross-sectional study. We used a structured demographic and clinical interview and Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19). Disability was rated by Expanded Disability Status Score (EDSS). 63.5% (n = 173) of women had SD included 142 (52.4%) women with primary SD, 102 (37.5%) women with secondary SD and 120 (41%) women with tertiary SD. The most common SD-related complaint was orgasmic problem (41.2%). Women with primary SD were significantly older and had higher EDSS score. No significant relationship was found between primary SD and disease duration. Fatigue (OR = 2.69, 95% CI: 1.352-5.385, P = 0.005), memory and concentration complaints ...
International Journal of MS Care, 2003
When health care professionals were asked about their perceptions of, assessment of, and treatment methods for sexual dysfunction, they acknowledged that sexual dysfunction was a frequent problem for MS patients, although few addressed the issue with their patients. Most also believed that very few of the patients actually sought help for sexual dysfunction. In addition to comfort level and training as the strongest predictors determining inquiry behavior, respondents indicated that lack of time with patients was an important factor in not inquiring about sexual function. As a whole, the group had minimal training in human sexuality. This questionnaire-based study found that amount of training was a significant predictor of both comfort level in discussing sexual functioning and the frequency in which discussions were initiated with patients. The results suggest that more training would facilitate MS health care professionals' comfort and assessment behaviors of sexual dysfuncti...
Sexual Function in Young Individuals With Multiple Sclerosis: Does Disability Matter?
The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses, 2018
Studies on the prevalence of sexual dysfunction (SD) in multiple sclerosis (MS) have shown that 40% to 80% of women and 50% to 90% of men have had sexual complaints. Sexual function is often disregarded during consultation with healthcare professionals, and SD is frequently underdiagnosed. The aim of this study was to investigate the prevalence of SD and its relationship to sociodemographic and disease-related factors, with regard to disability state, in a hospital cohort of MS patients, by using a semistructured interview. Of 130 screened outpatients, 87 met the inclusion criteria and completed the study. The mean age of the participants was 39.3 ± 8.3 years, with a disease duration of 8.3 ± 5.4 years and a mean Expanded Disability Status Scale (EDSS) score of 2.04 ± 0.19. Sexual function was evaluated by means of a semistructured interview, investigating a patient's 3 main life areas: sociodemographic information, illness perception, and sexuality. Approximately 70% of the pat...
Acta Neurologica Scandinavica, 2010
Female sexual functioning is a complex process involving physiological, psychosocial and interpersonal factors. Sexual dysfunction (SD) is frequent (40-74%) among women with multiple sclerosis (MS), reflecting neurological dysfunction, psychological factors, depression, side effects of medications and physical manifestations of the disease, such as fatigue and muscle weakness. A conceptual model for sexual problems in MS characterizes three levels. Primary SD includes impaired libido, lubrication, and orgasm. Secondary SD is composed of limiting sexual expressions due to physical manifestations. Tertiary SD results from psychological, emotional, social, and cultural aspects. Sexual problems cause distress and may affect the family bond. Practical suggestions on initiation of discussion of sexual issues for MS patients are included in this review. Assessment and treatment of sexual problems should combine medical and psychosexual approaches and begin early after MS diagnosis. Intervention can be done by recognizing sexual needs, educating and providing information, by letting patients express their difficulties and referring them to specialists and other information resources.
Determinants of sexual dysfunction in women with multiple sclerosis
BMC Neurology, 2013
Background: The aim of present study was to determine disease-related and psychological risk factors for sexual dysfunction in women with multiple sclerosis (MS). Methods: This was a clinical-based study conducted from September 2009 to June 2010 in Tehran, Iran. A consecutive sample of female patients with MS was recruited from an outpatient clinic. The Female Sexual Function Index (FSFI) was used to evaluate sexual function. In addition neurological impairment was measured using the Kurtzke Expanded Disability Status Scale (EDSS), and depression was assessed using the Beck Depression Inventory-II (BDI-II). Univariate and multiple logistic regression analyses were performed in order to examine the association between sexual dysfunction and independent variables. Results: In all, 226 women participated in the study. Of these, 125 women (55.3%) met the criteria for sexual dysfunction. The mean age of participants was 35.7 years (SD = 8.07). The results obtained from multiple logistic regression analysis indicated that the disease duration (OR for the disease duration of equal or greater than 9 years = 3.13, %95 CI = 1.29-7.57, P = 0.01), the disease course (OR for secondary progressive MS = 3.96, %95 CI = 1.55-10.10, P = 0.004) and the BDI score (OR = 1.11, %95 CI = 1.07-1.16, P < 0.001) were significant factors contributing to sexual dysfunction in these patients. Conclusions: The findings from this study indicated that the duration and severity of the disease in addition to depression were the most significant factors that contributed to sexual dysfunction in women with multiple sclerosis. The burden of disease and sexual dysfunction suggests the need for further attention to this patient population.