Sexual dysfunction in multiple sclerosis

Abstract

Multiple sclerosis is a chronic disease that commonly affects young adults who may be sexually active. Sexual dysfunction is a significant, but often underestimated, symptom of multiple sclerosis, affecting 50–90% of men and 40–80% of women. The types of sexual dysfunction can be categorized in terms of the normal sexual response cycle: sexual interest/desire dysfunction (reduced libido), sexual arousal dysfunction (including erectile dysfunction) and ejaculatory and orgasmic dysfunction. Sexual dysfunction may not only be due to lesions affecting the neural pathways involved in physiological function (primary dysfunction), but also result from general physical disabilities (secondary dysfunction) or psychological and emotional issues (tertiary dysfunction). Comprehensive management should address all these possible contributing problems. Specific pharmacotherapy is only currently available for erectile dysfunction. This review summarizes the available information about sexual dysfunction in men and women with multiple sclerosis.

Keywords::

• counseling
• diagnosis
• erectile dysfunction
• multiple sclerosis
• phosphodiesterase type 5 inhibitors
• prevalence
• sexual dysfunction
• symptoms
• treatment

Financial & competing interests disclosure

Thomas Kessler is supported by a grant from the Swiss National Science Foundation. This work was undertaken at the UCLH/UCL, who received a proportion of funding from the Department of Health’s NIHR Biomedical Research Centres funding scheme. Clare Fowler is a recipient of unrestricted educational grants from Allergan and has also acted as a consultant for Allergan and Medtronic. Thomas Kessler has acted as a consultant for Medtronic. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.