Sexual dysfunction in female and male people with multiple sclerosis: disability, depression and hormonal status matter

被引:5
作者
Di Pauli, Franziska [1 ]
Zinganell, Anne [1 ]
Boettcher, Bettina [2 ]
Walde, Janette [3 ]
Auer, Michael [1 ]
Barket, Robert [1 ]
Berek, Klaus [1 ]
Egger, Alexander [4 ]
Griesmacher, Andrea [4 ]
Sukalo, Natasa [1 ]
Deisenhammer, Florian [1 ]
Hegen, Harald [1 ]
机构
[1] Med Univ Innsbruck, Dept Neurol, Innsbruck, Austria
[2] Med Univ Innsbruck, Dept Gynecol Endocrinol & Reprod Med, Innsbruck, Austria
[3] Univ Innsbruck, Fac Econ & Stat, Dept Stat, Innsbruck, Austria
[4] Univ Hosp Innsbruck, Cent Inst Med, Chem Lab Diagnost ZIMCL, Innsbruck, Austria
关键词
depression; disability; Expanded Disability Status Scale; hormonal status; multiple sclerosis; sexual dysfunction; QUALITY-OF-LIFE; WOMEN; BLADDER; IMPACT; ASSOCIATION; DISORDERS; MEN;
D O I
10.1111/ene.15696
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and purpose: Sexual dysfunction (SD) in people with multiple sclerosis (pwMS) is common and an often underestimated issue in the care of pwMS. The objective of the study was to evaluate risk factors for SD in pwMS, correlate its prevalence with patient-reported measures (quality of life and physical activity) and analyse its association with hormonal status.Methods: Sexual dysfunction was determined in 152 pwMS using the Multiple Sclerosis Intimacy and Sexuality Questionnaire 19. A logistical regression model was used to identify independent risk factors for SD.Results: The prevalence of SD in pwMS was 47%. Independent risk factors for the development of SD were ever-smoking (odds ratio [OR] 3.4, p = 0.023), disability as measured by the Expanded Disability Status Scale (OR 2.0, p < 0.001), depression (OR 4.3, p = 0.047) and bladder and bowel dysfunction (OR 8.8, p < 0.001); the use of disease-modifying treatment was associated with a lower risk for SD (OR 0.32, p = 0.043). SD was associated with worse quality of life (Multiple Sclerosis Impact Scale 29: physical score 6.3 vs. 40.0; psychological score 8.3 vs. 33.3; both p < 0.001) and lower physical activity (Baecke questionnaire, p < 0.001). Laboratory analysis revealed significantly higher luteinizing hormone and follicle-stimulating hormone levels and lower 17-beta oestradiol, androstenedione, dehydroepiandrosterone sulfate, oestrone and anti-Mullerian hormone levels in female pwMS with SD. In male pwMS and SD, there was a significant decrease in inhibin B levels.Conclusions: Our findings highlight the requirement of a holistic approach to SD in MS including physical, neurourological and psychosocial factors. Active screening for SD, especially in patients with disability, depression or bladder and bowel dysfunction, is recommended.
引用
收藏
页码:991 / 1000
页数:10
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