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Identifying barriers to help-seeking for sexual dysfunction in multiple sclerosis

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Abstract

Background

Sexual dysfunction (SD) is common in multiple sclerosis (MS), however, under-reported.

Objective

The aim of this study was to identify barriers faced by patients with MS and healthcare professionals (HCPs) in discussing SD.

Methods

This was a two-part prospective study carried out at a tertiary care centre. Patients with MS were surveyed using a 29-item questionnaire and SD was assessed using the MSISQ and ASEX questionnaires; depression screened with PHQ-2. HCPs were surveyed using a 23-item questionnaire.

Results

Seventy four patients (mean age 42.4 ± 10.7, 54 females) and 98 HCPs (mean age 45.8 ± 8.9, 90 females) participated. SD was significant, with primary (36.4%), secondary (27%) and tertiary (29.8%) contributory factors. Commonest barriers reported by patients were dominance of neurological symptoms (N = 30, 40.5%), presence of family or friends (N = 28, 37.8%), and not being asked (N = 25, 33.8%), while HCPs reported presence of family or friends (N = 34, 34.7%), lack of knowledge about SD (N = 30, 30.6%), and inadequate time during the consultation (N = 27, 27.6%).

Conclusions

Barriers to discussing SD are similar between patients and HCPs. The most common barriers are addressable through modifications in the clinic environment, raising awareness and providing training opportunities.

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Acknowledgements

The work was undertaken at UCLH/UCL Institute of Neurology and JNP is supported in part by funding from the United Kingdom’s Department of Health NIHR Biomedical Research Centres funding scheme. KIT was awarded funding from International Continence Society (Urodynamics Fellowship), EFNS (Department—Department Cooperation Programme), Guarantors of Brain (Newsom—Davis Visiting Fellowship). MDL was supported by the Swiss National Science Foundatio24n (fellowship P2EZP3_148749 & P300PB_161087) and the MS society, UK. We would like to acknowledge support of the Multiple Sclerosis Trust of the United Kingdom for carrying out the study and Queen Square MS Centre for useful input during the study. We would like to thank Martina Doz for statistical support.

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Authors and Affiliations

  1. Department of Neurology, University Hospital Centre Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia

    Katarina Ivana Tudor

  2. Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, Queen Square, London, UK

    Katarina Ivana Tudor, S. Eames, C. Haslam, M. D. Liechti & J. N. Panicker

  3. Department of Neuroinflammation, Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, London, UK

    J. Chataway

  4. Neuro-Urology, Spinal Cord Injury Center and Research Lab Hospital, University of Zürich, Balgrist University, Zürich, Switzerland

    M. D. Liechti

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  1. Katarina Ivana Tudor
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Corresponding author

Correspondence to Katarina Ivana Tudor.

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Ethical approval

This prospective service evaluation was approved and registered with the Queen Square Division Quality and Clinical Governance Department.

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Tudor, K.I., Eames, S., Haslam, C. et al. Identifying barriers to help-seeking for sexual dysfunction in multiple sclerosis. J Neurol 265, 2789–2802 (2018). https://doi.org/10.1007/s00415-018-9064-8

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  • DOI: https://doi.org/10.1007/s00415-018-9064-8

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