- •In a cohort study of PwMS, 37.7% of participants reported low sexual function and 44.7% had low satisfaction. There was no significant difference in the prevalence of low function or satisfaction between males and females.
- •The association between disability and sexual function was only significant in females, and fatigue was only significant in its association with satisfaction in females.
- •Changes in fatigue, depression, and disability over time are associated with changes in sexual function and satisfaction, but age and disease duration were not.
- •All QOL domains are associated with sexual function and satisfaction. Males had stronger associations between sexual function and emotional roles, health perceptions, and overall QOL. They also had stronger associations between satisfaction and emotional roles, energy, social functioning, and physical health.
Low sexual function and satisfaction are common problems among people with multiple sclerosis (PwMS), but the literature on which patient variables are associated with these issues is inconsistent.
To investigate the associations between sexual function and satisfaction in PwMS with clinical, demographic, and patient-reported quality of life (QOL) measures and determine if sex differences exist.
This analysis includes PwMS enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women's Hospital (CLIMB), who completed patient-reported outcome measures: Multiple Sclerosis Quality of Life-54 (MSQOL-54), Modified Fatigue Impact Scale (MFIS), and Center for Epidemiologic Studies Depression Scale (CES-D). Regression models were used to analyze associations between patient variables and function and satisfaction. Results were stratified by sex. Cross-sectional and longitudinal data were used.
702 PwMS (526 females,176 males, mean age 42.2 +/-11.1, median EDSS 1.5) were included in the cross-sectional analysis. Data from 341 PwMS were used in the three-year longitudinal analysis. Increasing age, disease duration, and disability were associated with reduced sexual function and satisfaction to the same degree in males and females. However, sex differences existed in the strength of associations with QOL variables. There was no significant longitudinal change in females or males.
Age and disease duration were associated with reduced sexual function and satisfaction in males and females. In females, function was significantly associated with disability and satisfaction with fatigue. Males had stronger associations with sexual function in domains related to emotional well-being, health perceptions, and overall QOL. Males had stronger associations with satisfaction in emotional and social functioning and physical health domains. These findings can help better understand the multidimensional problems of sexual function and satisfaction in PwMS and better guide patient care.
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Published online: March 26, 2023
Accepted: March 25, 2023
Received in revised form: February 4, 2023
Received: September 23, 2022
© 2023 Elsevier B.V. All rights reserved.