Sexual function and related predictors in male with multiple sclerosis and neuromyelitis optica spectrum disorder: a case-control study

J Sex Med. 2024 Dec 30:qdae188. doi: 10.1093/jsxmed/qdae188. Online ahead of print.

Abstract

Background: Sexual dysfunction (SF) is a prevalent and distressing comorbidity in males with multiple sclerosis (MwMS) and neuromyelitis optica spectrum disorder (MwNMOSD).

Aims: This study aimed to assess the SF in MwMS and MwNMOSD in comparison to male healthy controls (HCs) and identify its associated predictors.

Methods: This case-control study was conducted from February 2023 to January 2024 at the MS clinic of Kashani Hospital, Isfahan, Iran. Participants included 49 MwMS, 27 MwNMOSD, and 40 HCs. Demographic, clinical, and psychological data were collected, and SF was evaluated by the International Index of Erectile Function (IIEF). Linear regression was used to assess relationships between variables.

Outcomes: SF was significantly worse in the MwMS and MwNMOSD compared to the HCs.

Results: SF was significantly lower in MwMS and MwNMOSD compared to HCs. In MwMS, significant independent predictors of SF included partner's education (B = -2.7, P = .003), anxiety (B = -0.6, P = .003), and depression (B = -0.3, P = .026). In MwNMOSD, significant independent predictors of SF were EDSS (B = -5.7, P = .007) and anxiety (B = -1, P = .002).

Clinical implications: Controlling risk factors such as depression and anxiety can improve SF of MwMS to a significant extent.

Strengths and limitations: Despite limitations like the cross-sectional design and exclusion of certain variables, our study identifies significant associations between sexual dysfunction and various risk factors in MwMS and MwNMOSD, emphasizing the need for future longitudinal research.

Conclusion: MwMS and MwNMOSD exhibited worse SF than HCs. Multiple factors have been identified as independent predictors of SF within these patient groups.

Keywords: multiple sclerosis; neuromyelitis optica spectrum disorder; sexual dysfunction; sexual function.