Female sexual dysfunctions in multiple sclerosis patients with lower urinary tract symptoms: an Italian case-control study.

Abstract

Multiple sclerosis (MS) is a recurrent, autoimmune, and inflammatory demyelinating chronic disease that typically manifests in young adulthood and exerts adverse effects on sexual functions. The study evaluated the prevalence of sexual dysfunctions (SDs) and the relationship with neurological disability, depression, and lower urinary tract symptoms (LUTS) in a cohort of MS female patients, comparing these results with those of healthy women. From January 2023 to January 2024, consecutive premenopausal female patients with MS, were recruited and the examination included urinalysis, ultrasonography and a urodynamic test according to the International Continence Society standard. Descriptive statistics were reported as mean and standard deviation for continuous variables (analyzed by independent samples Mann-Whitney U test and independent samples Kruskal-Wallis test) while categorical variables were reported as frequency and percentage (analyzed by chi-square test with Fisher's exact test). Female Sexual Function Index (FSFI) total score and all FSFI subscales scores were significantly lower in patients with MS vs healthy control subjects (P < .001); FSFI total scores and all FSFI subscale scores were statistically significantly lower in patients with MS with an International Prostate Symptom Score ≥20 (P < .001) and considering a cutoff for Beck Depression Inventory-II score ≥17, depression was present in 61% (n = 47 of 77) of patients with MS and completely absent in the control group. The knowledge that SDs are a common problem in MS and in other chronic illnesses can alleviate the feeling of stigma and talking openly of sexual problems can be helpful for the patients and so the doctor-patient relationship can be reinforced. The sample was drawn from a single center, and larger multicenter studies that include both genders are needed to obtain strong results. Our findings confirm the idea of a polygenic and multifactorial etiology of female SDs in MS. Therefore, women with MS should be evaluated in terms of SDs during follow-ups.