Sexual functioning in patients with multiple sclerosis and its association with social support and self-esteem

Effect of expressive writing on the sexual self-concept in men with multiple sclerosis: a randomized clinical controlled trial

BACKGROUND

Previous studies have examined the various outcomes of expressive writing intervention in different populations. The purpose of this study was to evaluate the effect of expressive writing on the sexual self-concept of men with multiple sclerosis.

METHODS

This parallel randomized controlled clinical trial conducted on 70 men attending an MS clinic in Tehran in 2022. The participants were randomly assigned to expressive writing intervention and control groups. For two weeks, participants in the intervention group disclosed their emotions and expressed their feelings in writing twice a week. Sexual self-concept was evaluated using the Multidimensional Sexual Self-Concept Questionnaire on three occasions, before, after, and 4-week follow-up. The data ware analyzed using SPSS software version 22 (IBM Corp., Armonk, N.Y., USA). The analysis employed Chi-squared test, Fisher's exact test, independent t-test, and repeated measured ANOVA. A p-value < 0.05 was considered to be statistically significant.

RESULTS

The mean of age in the intervention group was 38.6 ± 6.85 years, while in the control group it was 38.94 ± 6.07 years. There were no significant differences between the two groups, in terms of these characteristics. According to the results, the dimensions of SSC did not change over time assessments, except for sexual problem self-blame (p = 0.011) and sexual fear/apprehension (p = 0.042) in the expressive writing intervention group, and sexual motivation in the control group (p = 0.002). On the other hand, before the intervention, sexual motivation was significantly higher in the control group compared to the expressive writing intervention group (p = 0.046).

CONCLUSIONS

Our findings did not support the general effectiveness of a 2-week expressive writing intervention on the sexual self-concept of the men with MS except for the sexual fear/apprehension and sexual problem self-blame dimensions. However, further research is needed to better understand the effects of expressive writing intervention on Sexual self-concept in men with multiple sclerosis, while controlling for the limitations of our study.

TRIAL REGISTRATION

The present study has been registered on the Iranian Registry of Clinical Trials (IRCT) at https://irct.behdasht.gov.ir/trial/59664 on November 17, 2021, with the code IRCT20211028052892N1.

Prevalence and risk of developing sexual dysfunction in women with multiple sclerosis (MS): a systematic review and meta-analysis

OBJECTIVE

To estimate the pooled prevalence of sexual dysfunction (SD) in women with multiple sclerosis (MS).

METHODS

We systematically searched PubMed, Scopus, EMBASE, Web of Science, and google scholar and also gray literature up to October 2021. The search strategy includes: ("Multiple Sclerosis" OR "MS" OR "Disseminated Sclerosis" OR (Disseminated AND Sclerosis) OR (Sclerosis AND Multiple)) AND ("Sexual Dysfunction" OR (Sexual AND Dysfunction) OR (Sexual AND Dysfunctions) OR (Sexual AND Disorders) OR (Sexual AND Disorder) OR "Sexual Dysfunctions" OR "Sexual Disorders" OR "Sexual Disorder" OR "Psychosexual Dysfunctions" OR (Dysfunction AND Psychosexual) OR (Dysfunctions AND Psychosexual) OR "Psychosexual Dysfunction" OR "Psychosexual Disorders" OR (Disorder AND Psychosexual) OR (Disorders AND Psychosexual) OR "Psychosexual Disorder" OR "Hypoactive Sexual Desire Disorder" OR "Sexual Aversion Disorder" OR (Aversion Disorders AND Sexual) OR (Disorders AND Sexual Aversion) OR "Sexual Aversion Disorders" OR "Orgasmic Disorder" OR (Disorders AND Orgasmic) OR "Orgasmic Disorders" OR "Sexual Arousal Disorder" OR (Arousal Disorders AND Sexual) OR (Disorders AND Sexual Arousal) OR "Sexual Arousal Disorders" OR "Frigidity").

RESULTS

We found 2150 articles by literature search, after deleting duplicates 1760 remained. Fifty-six articles remained for meta-analysis. The pooled prevalence of SD in MS patients estimated as 61% (95%CI:56-67%) (I²:95.7%, P < 0.001). The pooled prevalence of Anorgasmia in MS patients estimated as 29% (95%CI:20-39%) (I²:85.3%, P < 0.001). The pooled odds of developing SD in MS women estimated as 3.05(95%CI: 1.74-5.35) (I²:78.3%, P < 0.001). The pooled prevalence of decreased vaginal lubrication in MS patients estimated as 32%(95%CI:27-37%) (I² = 94.2%, P < 0.001). The pooled prevalence of reduced libido was 48%(95%CI:36-61%) (I²:92.6%, P < 0.001). The pooled prevalence of arousal problems was 40%(95%CI: 26-54%) (I²:97.4%, P < 0.001). The pooled prevalence of intercourse satisfaction was 27% (95%CI: 8-46%) (I²:99%, P < 0.001).

CONCLUSION

The result of this systematic review and meta-analysis show that the pooled prevalence of SD in women with MS is 61% and the odds of developing SD in comparison with controls is 3.05.

Is erectile dysfunction related to self-esteem and depression? A prospective case-control study

Sexual activity is important role in life of men. Decreased sexual function has a negative impact on the quality of life of the patients and their partners. In this study, we aimed to evaluate the relationship of erectile dysfunction (ED) with self-esteem, symptom severity and depression. The 80 patients were evaluated prospectively. Group 1 (cases group) included 40 patients who with ED an age range of up to 18-70 years. Group 2 (healthy control group) included 40 patients who apply to the urology clinic for various reasons without ED. All patients were filled international index of erectile function-5 (IIEF-5), Beck Depression questionnaire (BDI-2) and Rosenberg self-esteem questionnaires (RESQ). Demographic characteristics and inventory results of the patients were compared between the two groups. Significant differences were found between the two groups in IIEF-5, RESQ and BDI-2 scores. In Group 1, IIEF-5 score was low, RESQ, BDI-2 scores were significantly higher (All scores p < 0.001). As a result people significantly reflect their sexual satisfaction in their social life. The patients with mild ED are not entirely satisfied in spite of normal sexual frequency. This situation causes significantly low the self-esteem of men. Prevention of ED will contribute to increased self-esteem and happy lives.