Sexual function in people with multiple sclerosis: a systematic review and meta-analysis

Area of Science:

• Neurology
• Sexual Medicine
• Quality of Life Research

Background:

• Sexual dysfunction (SF) is a prevalent and impactful issue for people with multiple sclerosis (PwMS).
• Understanding the factors influencing SF in PwMS is crucial for improving their overall well-being.

Purpose of the Study:

• To systematically review and synthesize evidence comparing sexual function in PwMS versus healthy controls (HCs).
• To investigate the correlations between sexual function and demographic, clinical, and psychological factors in PwMS.

Main Methods:

• A systematic literature search was conducted across major databases (PubMed/MEDLINE, Embase, Scopus, Web of Science) up to July 2024.
• Meta-analysis using random effects models was employed to calculate pooled standardized mean differences and correlations.

Main Results:

• The meta-analysis included 61 studies with 16,266 PwMS, revealing significantly reduced SF in PwMS compared to HCs.
• Females with MS (FwMS) showed lower Female Sexual Function Index scores (SMD: -0.41), and males with MS (MwMS) had reduced International Index of Erectile Function scores (SMD: -0.77).
• Reduced SF correlated with higher Expanded Disability Status Scale (EDSS) scores, longer disease duration, depression, and fatigue, particularly in FwMS.

Conclusions:

• Sexual function is demonstrably lower in PwMS compared to HCs.
• Age, disease duration, depression, and EDSS are significant influencing factors on SF in PwMS.
• Further research is recommended to explore the impact of comorbidities, medications, and MS classification on SF in PwMS.