Infection, inflammation, and sexual function in male and female patients-recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024)

Physiotherapy for Sexual Dysfunctions in Multiple Sclerosis Patients: A Review of Clinical Trials

Multiple Sclerosis (MS) is an inflammatory autoimmune disorder that primarily affects the central nervous system, leading to significant disability in young adults, with a higher prevalence observed in women. The heterogeneous clinical presentation of MS poses substantial challenges in diagnosis and treatment. In recent years, considerable emphasis has been placed on improving the quality of life for MS patients, with sexual health being a key component of this assessment. The literature suggests that sexual dysfunctions affect between 42% and 73% of individuals with MS. While the positive effects of physiotherapy interventions on sexual dysfunction have been extensively studied, there remains a significant gap in understanding the prevalence of these disorders within the MS population and the most effective treatment approaches. This review highlights the critical need to integrate pelvic floor physiotherapists into multidisciplinary MS treatment teams. Six randomized controlled trials (RCTs) meeting the inclusion criteria were identified. These studies included patients diagnosed with MS who reported various sexual dysfunctions, such as orgasmic dysfunction, sexual arousal disorders, and dysfunctions associated with overactive bladder. The outcomes were assessed using sexual function and urological symptom questionnaires. Physiotherapeutic interventions, including manual therapy, kinesiotherapy, and physical therapy elements, have demonstrated positive effects on sexual quality of life, specifically in relation to issues such as desire, arousal, and satisfaction. However, the available data are still preliminary and warrant further investigation. By recognizing the importance of pelvic floor therapy, more targeted and holistic interventions can be implemented, ultimately improving patient outcomes and enhancing the overall standard of care.