Assessment of sexual dysfunction in patients with multiple sclerosis: a perspective from neurologist

Abstract

Background Sexual dysfunction (SD) is a common comorbidity in people with multiple sclerosis (pwMS). It affects the quality of life and remains an overlooked condition. The objective of this study was to describe how Colombian neurologists assess and treat SD and explore the barriers during sexual function evaluation. Methods In this observational cross-sectional study we developed a questionnaire for neurologists with 4 sections (demographic data, evaluation and treatment of SD, and possible reasons for not discussing sexual dysfunction.) It was sent via email to 326 Colombian neurologists. We grouped the answers according to the type of consultation (neurologists from a MS program or no MS program). We described through absolute frequencies and proportions. Results Fifty neurologists answered the survey. 64% stated that they usually study sexual dysfunction in neurological disorders. The main methods employed were private reading (86%) and attending conferences (14%). 5/50 participants have never attend pwMS; the Sect. 2–4 was not answered by them. 29% work in a MS program, all of them asked their patients about sexual function, but 18.75% of physicians working outside an MS program have never asked about it. Main reasons for not talking about sexual dysfunction were lack of knowledge (65.1%), presence of a companion (65.1%) and lack of time (55.8%). 91% of the neurologists reported that their patients usually and frequently ask about sexual function. Neurologists use informal questions to assess sexual function (80%), although 64.4% said that they are aware of SD questionnaires. When sexual dysfunction is detected, 91% of neurologists refer patients to another specialist and 87% do not start any treatment. Conclusions Colombian neurologists are concerned with sexual function in pwMS, however it remains an underdiagnosed an undertreated condition. It is necessary to strengthen knowledge about the diagnosis and treatment of sexual dysfunction in pwMS, for neurologists and patients. It is also imperative to eliminate barriers around the topic and include sexual function evaluation and treatment as the routine care of pwMS.

Sexual Dysfunction in People with Multiple Sclerosis: The Role of Disease Severity, Illness Perception, and Depression

“…Namely, our results showed that both illness perceptions and depressive symptoms can influence sexual dysfunction in pwMS, particularly when the disability is not severe, suggesting that helping pwMS process these dimensions may promote sexual health and well-being. Because sexual dysfunction is known to be inadequately addressed by clinicians working with pwMS [ 41 ], clinicians should first integrate sexual dysfunction assessment into their clinical approach [ 42 ]. In the case of sexual functioning impairment and after biological causes have been ruled out, clinicians should assess the potential role of illness perceptions and depressive symptoms in determining this impairment.…”

Reliability, Validity and Distribution of the Spanish Female Sexual Function Index in Women with Multiple Sclerosis

“…In a study by Altman and colleagues, in which MS doctors were surveyed regarding their approach to taking a sexual history of their patients, only 15% reported discussing sexuality with every patient. The lack of evaluation of SD during consultation leads to the remaining as an underdiagnosed and undertreated condition [91]. The most common reason for not doing so was a fear of crossing personal boundaries, lack of spontaneous communication by patients [92] or lack of knowledge [93].…”