Sclérose en plaques et sexualité : un modèle complexe

[Female sexual dysfunction and multiple sclerosis: A case-control study]

OBJECTIVES

To compare the scores of the different dimensions of sexual function of women with multiple sclerosis to a group of control women and to identify possible factors associated with sexual dysfunction in women with multiple sclerosis.

METHODS

This is a descriptive and analytical case-control study. Twenty-six women with multiple sclerosis were compared to 26 control women matched for age and socioeconomic status. The evaluation focused on demographic and clinical data. Patients with multiple sclerosis were evaluated by Expanded Disability Status Scale (EDSS) for functional status, by Female Sexual Function Inventory (FSFI) for sexual function and by Beck Depression Inventory-Short Form (BDI-DF) for severity of depression.

RESULTS

Our results confirmed the high prevalence of sexual dysfunction among patients with multiple sclerosis (69.2%) compared to controls (26.9%) (P=0.002). Sexual desire, arousal and orgasm were the most altered sexual phases in our study. Total FSFI, and FSFI subscale scores (sexual desire, arousal, lubrication, orgasm and satisfaction) were lower in women with multiple sclerosis compared with controls. The analytical study showed that in women with multiple sclerosis, the total FSFI score was correlated with age (r_s=-0.68; P<0.001), duration of marriage (r_s=-0.57; P=0.002), level of disability (r_s=-0.45; P=0.021) and BDI-SF score (r_s=-0.51; P=0.008). FSFI score was also associated to low education level (P=0.02) and urinary dysfunction (P=0.04).

CONCLUSION

Our study highlighted the importance of sexual dysfunction in women with multiple sclerosis. The inclusion of this aspect in the clinical assessment will improve the quality of life of these patients.

LEVEL OF EVIDENCE

3.

[Improving the sexual quality of life of people with multiple sclerosis]

Helping people with a chronic disease with regard to their sexual wellbeing is part of the nurse's role. In order to be able to offer this support the nurse requires training and needs to work in collaboration with medical staff. The approach consists in assessing the disorders linked to the disease or its treatment which affect the patient's sexual quality of life, advising on potential solutions using medication or mechanical devices and providing the patient with personalised guidance.

[Sexual function, physical handicap]

While the right to a sexual life for disabled people is not contested, their sexuality cannot be summed up in a debate for or against sexual assistance. In a similar way, sexual function can only be understood in light of all the difficulties related to disability. Medical progress can improve sexual function and solve many problems in order to facilitate access to procreation. However, these are not well known and are reserved to specialized teams. Many disabled persons are totally autonomous in their sexuality, but for some who require medical assistance, it is necessary to support them in a process of creation where therapeutic interventions consist of facilitating or stimulating the patient's own resources.