Abstract
PurposeThe diagnosis of probable multiple system atrophy relies on the presence of severe cardiovascular or urogenital autonomic failure. Erectile dysfunction is required to fulfil the latter criterion in men, whereas no corresponding item is established for women. In this study, we aimed to investigate sexual dysfunction in women with multiple system atrophy.MethodsWe administered the Female Sexual Function Index questionnaire and interviewed women with multiple system atrophy and age-matched controls regarding the presence of “genital hyposensitivity.”ResultsWe recruited 25 women with multiple system atrophy and 42 controls. Female Sexual Function Index scores in sexually active women with multiple system atrophy were significantly lower (multiple system atrophy = 10; 15.4, 95% CI [10.1, 22.1], controls = 37; 26.1 [24.1, 28.1], p = 0.0004). The lowest scores concerned the domains of desire, arousal and lubrication. Genital hyposensitivity was reported by 56% of the patients with multiple system atrophy and 9% controls (p < 0.0001).ConclusionsSexual dysfunction is highly prevalent in women with multiple system atrophy. Screening for disturbances in specific sexual domains should be implemented in the clinical evaluation of women with suggestive motor symptoms.
Highlights
Autonomic dysfunction is a cardinal feature of synucleinopathies, and it is most severe in multiple system atrophy (MSA), a progressive, fatal disorder, which features a combination of parkinsonian and/or cerebellar motor signs along with autonomic failure [1]
The present study addressed the characterization of sexual function in women with MSA, an issue which has been neglected by the clinical research in the field [1]
Our findings show that sexual dysfunction is highly prevalent in female patients with MSA, regardless of the motor subtype
Summary
Autonomic dysfunction is a cardinal feature of synucleinopathies, and it is most severe in multiple system atrophy (MSA), a progressive, fatal disorder, which features a combination of parkinsonian and/or cerebellar motor signs along with autonomic failure [1]. The clinical diagnosis of MSA at a probable level of certainty requires the presence of severe cardiovascular or urogenital autonomic dysfunction [1]. Erectile dysfunction in addition to urinary incontinence is required to fulfil the urogenital dysfunction criterion in male patients [1]. While genital disorders are well described for male patients with MSA [2,3,4,5], there is a lack of information about sexual symptoms in women with MSA. One study has evaluated sexual function in women with the parkinsonian variant of MSA (MSA-P), investigating the presence of “genital hyposensitivity” [6]. Instruments which explore sexual function in female patients with MSA are virtually
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