Prevalence of sexual dysfunction in men with multiple sclerosis: a systematic review and meta-analysis

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Abstract

Background

Symptoms in multiple sclerosis (MS) can lead to different types and ranges of sexual dysfunction in MS patients. Studies in different parts of the world have reported a high range of sexual dysfunction in men with MS. This study aimed to estimate pooled prevalence of sexual dysfunction in men with MS.

Methods

The authors searched Web of Science, PubMed, Scopus, Embase, Magiran, SID, and Iran Medical Papers Database using the keywords “multiple sclerosis”, “sexual dysfunctions”, “men”, “prevalence”, and their synonyms systematically. Meta-analysis was performed using the random effects model with inverse variance-weighted method to estimate the overall prevalence of sexual dysfunction in men with MS. The protocol for this meta-analysis is available in PROSPERO (ID CRD42020199005).

Results

A total of 351 documents were identified, and 20 articles published from 1996 to 2019 were analyzed. The articles used sample sizes from 9 to 101 individuals. However, two studies conducted online used 388 and 1568 samples. Prevalence of sexual dysfunction in all studies was reported from 31 to 92%, and the pooled prevalence of sexual dysfunction in men with MS in all studies was 62.9% with a 95% confidence interval 53 to 72.7% (heterogeneity: I ² = 96.3%, Q-statistic = 12.48, P value < 0.001). According to the results of Egger’s test, there was publication bias in the current study ( β = 4.55, Se = 1.38, P value = 0.004).

Conclusion

Sexual dysfunction is highly prevalent in men with MS. Diagnosing sexual dysfunction in MS patients in clinics by specialists have to be considered a necessity.

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Most cited references 26

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Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement.

Damian Hoy, Peter Brooks, Anthony Woolf … (2012)

In the course of performing systematic reviews on the prevalence of low back and neck pain, we required a tool to assess the risk of study bias. Our objectives were to (1) modify an existing checklist and (2) test the final tool for interrater agreement. The final tool consists of 10 items addressing four domains of bias plus a summary risk of bias assessment. Two researchers tested the interrater agreement of the tool by independently assessing 54 randomly selected studies. Interrater agreement overall and for each individual item was assessed using the proportion of agreement and Kappa statistic. Raters found the tool easy to use, and there was high interrater agreement: overall agreement was 91% and the Kappa statistic was 0.82 (95% confidence interval: 0.76, 0.86). Agreement was almost perfect for the individual items on the tool and moderate for the summary assessment. We have addressed a research gap by modifying and testing a tool to assess risk of study bias. Further research may be useful for assessing the applicability of the tool across different conditions. Copyright © 2012 Elsevier Inc. All rights reserved.

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The impact of sexual dysfunction on the quality of life measured by MSQoL-54 in patients with multiple sclerosis.

D Tepavcevic, J Kostic, I D Basuroski … (2008)

Sexual dysfunction (SD) is a common but often overlooked symptom in multiple sclerosis (MS). The aim of this study was to estimate the frequency, type, and intensity of SD in our patients with MS and to investigate its influence on all the domains of quality of life. The study population comprised a cohort of 109 patients with MS (McDonald's criteria, 2001). SD was quantified by a Szasz sexual functioning scale. Health-related quality of life was measured by a disease-specific instrument MSQoL-54 (Serbian version). The presence of at least one symptom of SD was found in about 84% of the men and in 85% of the women. The main complaints in women were reduced libido, difficulties in achieving orgasm, and decreased vaginal lubrication; in men, the main complaints were reduced libido, incomplete erections, and premature ejaculation. In women, statistically significant negative correlations between the presence and level of SD and quality of life domains were reached for all subscales (P < 0.01), except for the Pain subscale (P = 0.112). In men, negative correlations were also observed for all domains, but they were statistically significant for physical health, physical role limitations, social function, health distress, sexual function, and sexual function satisfaction (P < 0.01). We found that the presence of all the analyzed types of sexual problems statistically significantly lowered scores on the sexual function and the sexual function satisfaction subscales in both men and women (P < 0.01). The most prominent impact on both domains was observed for the total loss of erection in men and for anorgasmia in women. Our results reveal that frequent occurrence of SD in MS patients prominently affects all aspects of their quality of life.

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Sexual dysfunction ın multiple sclerosis: gender differences.

Derya Kaya, Esra Coskuner Poyraz, Ayhan Bingöl … (2013)

To assess the frequency and nature of sexual dysfunction in multiple sclerosis (MS) patients and to investigate the relationships of SD with clinical, demographic and psychosocial factors by comparing MS patients with and without SD. Eighty-nine patients were included, 45 males and 44 females, aging an average of 37.4 ± 8.6 years (range:21-56). We applied Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) and Arizona Sexual Experiences Scale (ASEX) to all patients. Disability was evaluated with the expanded disability status scale (EDSS). 60.7% (n=54) of patients reported SD according to MSISQ scores. Women exhibited significantly higher MSISQ scores than men (42.6 ± 12.9 and 36.6 ± 13.3, respectively; P=0.034). Women (7.9%) also reported to experience sexual arousal difficulties significantly more than men (1.1%) (P=0.024) according to ASEX. The patients were classified into three MSISQ-19 subscales, Primary, Secondary and Tertiary SD. The most common reported dimension of SD was secondary (32.5%, n=41). In this dimension of SD, patients mostly complained of pain-burning, memory-concentration problems and bowel symptoms. A significant relationship was found between Secondary SD and both EDSS score and disease duration (r=0.34 p=0.001 and r=0.21 p=0.042, respectively). Tertiary SD was also associated with EDSS score (r=0.23 p=0.03). Sexual Dysfunction, a frequent problem for MS patients, is associated with gender. Women reported more SD than men. Secondary SD symptoms were the most common complaints for both men and women. Nonetheless women had more secondary SD symptoms than men. The emotional dimension of SD is related with disability. Copyright © 2012 Elsevier B.V. All rights reserved.

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Author and article information

Contributors

Maryam Dastoorpoor: mdastoorpour@yahoo.com

Maryam Zamanian: zamanian.m2015@gmail.com

Rahmatollah Moradzadeh: moradzadehr@yahoo.com

Seyed Massood Nabavi: seyedmassoodnabavi@gmail.com

Raana Kousari: raana.kousari@gmail.com

Journal

Journal ID (nlm-ta): Syst Rev

Journal ID (iso-abbrev): Syst Rev

Title: Systematic Reviews

Publisher: BioMed Central (London )

ISSN (Electronic): 2046-4053

Publication date (Electronic): 6 January 2021

Publication date PMC-release: 6 January 2021

Publication date Collection: 2021

Volume: 10

Electronic Location Identifier: 10

Affiliations

[1 ]GRID grid.411230.5, ISNI 0000 0000 9296 6873, Department of Biostatistics and Epidemiology, Social Determinants of Health Research Center, , Ahvaz Jundishapur University of Medical Sciences, ; Ahvaz, Iran

[2 ]GRID grid.468130.8, ISNI 0000 0001 1218 604X, Department of Epidemiology, School of Health, , Arak University of Medical Sciences, ; Arak, Iran

[3 ]GRID grid.419336.a, ISNI 0000 0004 0612 4397, Department of Brain and Cognitive Sciences, , Royan Institute for Stem Cell Biology and Technology, ACCR, ; Royan, Iran

[4 ]Dezful University of Medical Sciences, Dezful, Iran

Article

Publisher ID: 1560

DOI: 10.1186/s13643-020-01560-x

PMC ID: 7789133

PubMed ID: 33407874

SO-VID: 49b60b4e-e0d6-4705-838c-a17aeed7a7fe

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 15 October 2020

Date accepted : 15 December 2020

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100005001, Ahvaz Jundishapur University of Medical Sciences;

Award ID: IR.AJUMS.REC.1399.466

Award Recipient : Maryam Dastoorpoor

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ScienceOpen disciplines: Public health

Keywords: prevalence,multiple sclerosis,sexual dysfunction,men,systematic review

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ScienceOpen disciplines: Public health

Keywords: prevalence, multiple sclerosis, sexual dysfunction, men, systematic review

Prevalence of sexual dysfunction in men with multiple sclerosis: a systematic review and meta-analysis

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Most cited references 26

Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement.

The impact of sexual dysfunction on the quality of life measured by MSQoL-54 in patients with multiple sclerosis.

Sexual dysfunction ın multiple sclerosis: gender differences.

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