Skip to main content
SpringerLink
Log in

Sexual Dysfunction in Women with Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis

  • Original Paper
  • Published:
Sexuality and Disability Aims and scope Submit manuscript

Abstract

Sexual dysfunction (SD) is a common and significant complication in neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS), though it is often neglected and undertreated. We aimed to compare female sexual dysfunction in patients with NMOSD and MS, and investigate the association between clinical characteristics and SD. In this cross-sectional study, 36 patients with NMOSD and 312 MS patients who visited the MS clinic of Kashani Hospital were recruited. Sexual dysfunction was evaluated using the Iranian version of the Female Sexual Function Index (FSFI) questionnaire. Fatigue, depression, and anxiety were also assessed by fatigue severity score (FSS), Beck depression inventory-II (BDI-II), and Hamilton anxiety rating scale (HAM-A), respectively. Sexual dysfunction was presented in 75% of NMOSD and 63.5% of MS patients (P = 0.127). The most frequent SD problem in both NMOSD and MS was dysfunctional arousal (50% vs. 48.1%, P = 0.855). The frequency and mean score of sexual pain dysfunction in NMOSD patients was higher than MS, but it did not remain significant in the adjusted model. No statistically significant differences in the frequency and mean scores of other SD subdomains were detected. In the univariate model, only fatigue was associated with the presence of SD in NMOSD. In MS patients, depression was an independent risk factor of SD in the multivariate model. Our results confirm that SD is a common problem in female NMOSD and MS patients. Further longitudinal studies are needed to evaluate sexual dysfunction and its risk factors in NMOSD. In addition, attention to the management of depression and fatigue could be positively effective on sexual dysfunction in patients with NMOSD and MS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Availability of Data and Material

Anonymized data of this study will be available from the corresponding author on reasonable request from any qualified investigator, following the General Data Protection Regulation.

References

  1. Wingerchuk, D.M.: Neuromyelitis optica spectrum disorders. Continuum (Minneapolis, Minn) 16((5 Multiple sclerosis)), 105–121 (2010)

    Google Scholar 

  2. Lennon, V.A., Wingerchuk, D.M., Kryzer, T.J., Pittock, S.J., Lucchinetti, C.F., Fujihara, K., et al.: A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet 364(9451), 2106–2112 (2004)

    Article  PubMed  Google Scholar 

  3. Pittock, S.J., Lennon, V.A., Krecke, K., Wingerchuk, D.M., Lucchinetti, C.F., Weinshenker, B.G.: Brain abnormalities in neuromyelitis optica. Arch. Neurol. 63(3), 390–396 (2006)

    Article  PubMed  Google Scholar 

  4. Wingerchuk, D.M., Lennon, V., Pittock, S., Lucchinetti, C., Weinshenker, B.: Revised diagnostic criteria for neuromyelitis optica. Neurology 66(10), 1485–1489 (2006)

    Article  PubMed  Google Scholar 

  5. Dastoorpoor, M., Zamanian, M., Moradzadeh, R., Nabavi, S.M., Kousari, R.: Prevalence of sexual dysfunction in men with multiple sclerosis: a systematic review and meta-analysis. Syst. Rev. 10(1), 1–9 (2021)

    Article  Google Scholar 

  6. Zorzon, M., Zivadinov, R., Bosco, A., Bragadin, L.M., Moretti, R., Bonfigli, L., et al.: Sexual dysfunction in multiple sderosis: a case-control study. 1. Frequency and comparison of groups. Multiple Sclerosis J. 5(6), 418–427 (1999)

    Google Scholar 

  7. Contentti, E.C., Pettinicchi, J.P., Caride, A., López, P.A.: Sexual dysfunction in patients with multiple sclerosis from Argentina: what are the differences between women and men? Sex. Disabil. 37(4), 521–539 (2019)

    Article  Google Scholar 

  8. Drulovic J., Kisic-Tepavcevic D., Pekmezovic T. Epidemiology, diagnosis and management of sexual dysfunction in multiple sclerosis. Acta. Neurol. Belgica. 2020:1–7.

  9. Zivadinov, R., Zorzon, M., Locatelli, L., Stival, B., Monti, F., Nasuelli, D., et al.: Sexual dysfunction in multiple sclerosis: a MRI, neurophysiological and urodynamic study. J. Neurol. Sci. 210(1–2), 73–76 (2003)

    Article  PubMed  Google Scholar 

  10. Zorzon, M., Zivadinov, R., Locatelli, L., Stival, B., Nasuelli, D., Bratina, A., et al.: Correlation of sexual dysfunction and brain magnetic resonance imaging in multiple sclerosis. Mult. Scler. J. 9(1), 108–110 (2003)

    Article  Google Scholar 

  11. Mohammadi, K., Rahnama, P., Rafei, Z., Ebrahimi-Aveh, S.M., Montazeri, A.: Factors associated with intimacy and sexuality among young women with multiple sclerosis. Reprod. Health 17(1), 1–6 (2020)

    Article  Google Scholar 

  12. Bahmani D.S., Motl R.W.: Rate, burden, and treatment of sexual dysfunction in multiple sclerosis: The case for exercise training as a new treatment approach. Multiple Sclerosis Relat. Disorders. 2021:102878.

  13. Zivadinov, R., Zorzon, M., Bosco, A., Bragadin, L.M., Moretti, R., Bonfigli, L., et al.: Sexual dysfunction in multiple sderosis: II Correlation analysis. Multiple Sclerosis J. 5(6), 428–431 (1999)

    Google Scholar 

  14. Zhang, Y., Zhang, Q., Shi, Z., Chen, H., Wang, J., Yan, C., et al.: Sexual dysfunction in patients with neuromyelitis optica spectrum disorder. J. Neuroimmunol. 338, 577093 (2020)

    Article  PubMed  Google Scholar 

  15. Beekman J, Keisler A, Pedraza O, Haramura M, Gianella-Borradori A, Katz E, et al. 2019 Neuromyelitis optica spectrum disorder: patient experience and quality of life. Neurol. Neuroimmunol. Neuroinflammat. 6(4).

  16. Sakakibara, R.: Neurogenic lower urinary tract dysfunction in multiple sclerosis, neuromyelitis optica, and related disorders. Clin. Auton. Res. 29(3), 313–320 (2019)

    Article  PubMed  Google Scholar 

  17. Barzegar, M., Badihian, S., Mirmosayyeb, O., Ashtari, F., Jamadi, M., Emami, S., et al.: Comparative study of quality of life, anxiety, depression, and fatigue among patients with neuromyelitis optica spectrum disorder and multiple sclerosis: the first report from Iran. Multiple Sclerosis Relat. Disorders. 22, 161–165 (2018)

    Article  Google Scholar 

  18. Shin J.S., Kwon Y.N., Choi Y., Lee J.Y., Lee Y.I., Hwang J.H., et al. Comparison of psychiatric disturbances in patients with multiple sclerosis and neuromyelitis optica. Medicine. 2019 98(38).

  19. Kim, H.J., Paul, F., Lana-Peixoto, M.A., Tenembaum, S., Asgari, N., Palace, J., et al.: MRI characteristics of neuromyelitis optica spectrum disorder: an international update. Neurology 84(11), 1165–1173 (2015)

    Article  PubMed  PubMed Central  Google Scholar 

  20. Wingerchuk, D.M., Banwell, B., Bennett, J.L., Cabre, P., Carroll, W., Chitnis, T., et al.: International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology 85(2), 177–189 (2015)

    Article  PubMed  PubMed Central  Google Scholar 

  21. Polman, C.H., Reingold, S.C., Banwell, B., Clanet, M., Cohen, J.A., Filippi, M., et al.: Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann. Neurol. 69(2), 292–302 (2011)

    Article  PubMed  PubMed Central  Google Scholar 

  22. Thompson, A.J., Banwell, B.L., Barkhof, F., Carroll, W.M., Coetzee, T., Comi, G., et al.: Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 17(2), 162–173 (2018)

    Article  PubMed  Google Scholar 

  23. Polman, C.H., Reingold, S.C., Edan, G., Filippi, M., Hartung, H.P., Kappos, L., et al.: Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria.” Ann. Neurol. Official J. Am. Neurol. Assoc. Child Neurol. Soc. 58(6), 840–846 (2005)

    Google Scholar 

  24. Mirmosayyeb, O., Brand, S., Barzegar, M., Afshari-Safavi, A., Nehzat, N., Shaygannejad, V., et al.: Clinical characteristics and disability progression of early-and late-onset multiple sclerosis compared to adult-onset multiple sclerosis. J. Clin. Med. 9(5), 1326 (2020)

    Article  PubMed Central  Google Scholar 

  25. Kurtzke, J.F.: Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33(11), 1444 (1983)

    Article  PubMed  Google Scholar 

  26. Rosen, C.B., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., Ferguson, D., D’Agostino, R.: The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J.Sex Marital Therapy. 26(2), 191–208 (2000)

    Article  Google Scholar 

  27. Mohammadi, K.H., Heydari, M., Faghihzadeh, S.: The female sexual function Index (FSFI): validation of the Iranian version. Payesh. 7(3), 1680–7626 (2008)

    Google Scholar 

  28. Krupp, L.B., LaRocca, N.G., Muir-Nash, J., Steinberg, A.D.: The fatigue severity scale: application to patients with multiple sclerosis and systemic lupus erythematosus. Arch. Neurol. 46(10), 1121–1123 (1989)

    Article  PubMed  Google Scholar 

  29. Ghajarzadeh, M., Jalilian, R., Eskandari, G., Ali Sahraian, M., Reza, A.A.: Validity and reliability of Persian version of Modified Fatigue Impact Scale (MFIS) questionnaire in Iranian patients with multiple sclerosis. Disabil. Rehabil. 35(18), 1509–1512 (2013)

    Article  PubMed  Google Scholar 

  30. Ghassemzadeh, H., Mojtabai, R., Karamghadiri, N., Ebrahimkhani, N.: Psychometric properties of a Persian-language version of the Beck Depression Inventory-Second edition: BDI-II-PERSIAN. Depress. Anxiety 21(4), 185–192 (2005)

    Article  PubMed  Google Scholar 

  31. Beck, A.T., Steer, R.A., Ball, R., Ranieri, W.F.: Comparison of Beck depression inventories-IA and-II in psychiatric outpatients. J. Pers. Assess. 67(3), 588–597 (1996)

    Article  PubMed  Google Scholar 

  32. Hamilton, M.: The assessment of anxiety states by rating. Psychol. Psychother. Theory Res. Pract. 32(1), 50–55 (1959)

    Google Scholar 

  33. B G. Assessment of cognitive patterns among comorbid depression and anxiety patients. Tehran, Iran: Tehran Institute of Psychiatry. 1993.

  34. Lombardi, G., Musco, S., Kessler, T.M., Marzi, V.L., Lanciotti, M., Del Popolo, G.: Management of sexual dysfunction due to central nervous system disorders: a systematic review. BJU Int. 115, 47–56 (2015)

    Article  PubMed  Google Scholar 

  35. McCabe, M.P.: Exacerbation of symptoms among people with multiple sclerosis: impact on sexuality and relationships over time. Arch. Sex. Behav. 33(6), 593–601 (2004)

    Article  PubMed  Google Scholar 

  36. Tudor, K.I., Eames, S., Haslam, C., Chataway, J., Liechti, M., Panicker, J.: Identifying barriers to help-seeking for sexual dysfunction in multiple sclerosis. J. Neurol. 265(12), 2789–2802 (2018)

    Article  PubMed  Google Scholar 

  37. Blazquez, A., Ruiz, E., Aliste, L., García-Quintana, A., Alegre, J.: The effect of fatigue and fibromyalgia on sexual dysfunction in women with chronic fatigue syndrome. J. Sex Marital Ther. 41(1), 1–10 (2015)

    Article  PubMed  Google Scholar 

  38. Fabre, L.F., Smith, L.C.: The effect of major depression on sexual function in women. J. Sex. Med. 9(1), 231–239 (2012)

    Article  PubMed  Google Scholar 

  39. Bruce, T.J., Barlow, D.H.: The nature and role of performance anxiety in sexual dysfunction. Handbook of social and evaluation anxiety, pp. 357–384. Springer (1990)

    Book  Google Scholar 

  40. Ramezani M.A., Ahmadi K., Ghaemmaghami A., Marzabadi E.A., Pardakhti F. Epidemiology of sexual dysfunction in Iran: a systematic review and meta-analysis. Int. J. Prevent. Med. 2015;6.

  41. Kessler, T.M., Fowler, C.J., Panicker, J.N.: Sexual dysfunction in multiple sclerosis. Expert Rev. Neurother. 9(3), 341–350 (2009)

    Article  PubMed  Google Scholar 

  42. O’Donohue, W.T., Benuto, L.T., Tolle, L.W.: Handbook of adolescent health psychology. Springer (2013)

    Book  Google Scholar 

  43. Bradl, M., Kanamori, Y., Nakashima, I., Misu, T., Fujihara, K., Lassmann, H., et al.: Pain in neuromyelitis optica—prevalence, pathogenesis and therapy. Nat. Rev. Neurol. 10(9), 529 (2014)

    Article  PubMed  Google Scholar 

  44. Sorensen J, Bautista KE, Lamvu G, Feranec J. Evaluation and treatment of female sexual pain: a clinical review. Cureus. 2018;10(3).

  45. Lew-Starowicz, M., Rola, R.: Prevalence of sexual dysfunctions among women with multiple sclerosis. Sex. Disabil. 31(2), 141–153 (2013)

    Article  PubMed  PubMed Central  Google Scholar 

  46. Hayes, R., Dennerstein, L.: The impact of aging on sexual function and sexual dysfunction in women: a review of population-based studies. J. Sex. Med. 2(3), 317–330 (2005)

    Article  PubMed  Google Scholar 

  47. Demirkiran, M., Sarica, Y., Uguz, S., Yerdelen, D., Aslan, K.: Multiple sclerosis patients with and without sexual dysfunction: are there any differences? Mult. Scler. J. 12(2), 209–211 (2006)

    Article  Google Scholar 

  48. Darija, K.-T., Tatjana, P., Goran, T., Nebojsa, S., Irena, D., Sarlota, M., et al.: Sexual dysfunction in multiple sclerosis: a 6-year follow-up study. J. Neurol. Sci. 358(1–2), 317–323 (2015)

    Article  Google Scholar 

  49. Baldwin, D.S.: Depression and sexual dysfunction. Br. Med. Bull. 57(1), 81–99 (2001)

    Article  PubMed  Google Scholar 

Download references

Funding

This research did receive specific Grant from Vice-Chancellor for Research and Technology of Isfahan University of Medical Science.

Author information

Authors and Affiliations

  1. Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

    Omid Mirmosayyeb, Mahdi barzegar & Vahid Shaygannejad

  2. Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

    Omid Mirmosayyeb, Mahdi barzegar, Amirhossein Nafari, Ali Mahdi Hosseinabadi, Ali Malekzadeh, Majid Ghasemi, Sabora Barzegar & Vahid Shaygannejad

  3. Department of Clinical Biochemistry, Factually of Medical Science, Tarbiat Modares University, Tehran, Iran

    Amirhossein Nafari

  4. Department of Epidemiology and Biostatistics, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran

    Rasool Mohammadi

Authors
  1. Omid Mirmosayyeb
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mahdi barzegar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Amirhossein Nafari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ali Mahdi Hosseinabadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ali Malekzadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Majid Ghasemi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sabora Barzegar
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Rasool Mohammadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Vahid Shaygannejad
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: OM, MB, AN, VS; Methodology: OM, MB, AM, SB, VS; Formal analysis and investigation: OM, MB, AN, AMH, AM, MG; Writing—original draft preparation: MB, AN; Writing—review and editing: OM, MB; Funding acquisition: VS; Resources: VS; Supervision: VS.

Corresponding author

Correspondence to Vahid Shaygannejad.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics Approval

Regional bioethics committee of Isfahan University of Medical Sciences (IR.MUI.MED.REC.1398.583) approved this study.

Consent for Publication

Written informed consent for publication of their clinical details and/or clinical images was obtained from the patient/parent/guardian/ relative of the patient.

Consent to Participate

All participants received an written consent form and were assured of data confdentiality. Participants who consented to participate were then forwarded to the survey.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 18 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mirmosayyeb, O., barzegar, M., Nafari, A. et al. Sexual Dysfunction in Women with Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis. Sex Disabil 40, 381–392 (2022). https://doi.org/10.1007/s11195-022-09731-5

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11195-022-09731-5

Keywords

Search

Navigation