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<p>Sexual dysfunction affects up to 90% of women with multiple sclerosis (MS) and remains underaddressed due to limited knowledge, lack of privacy in consultations, and societal stigma, underscoring the need for effective interventions. This randomized controlled trial evaluated whether a sexual counseling intervention based on the Extended Permission, Limited Information, Specific Suggestions, and Intensive Therapy (EX-PLISSIT) model was associated with improvements in sexual function and satisfaction among women with MS in Turkey. Conducted at a university hospital in Turkey (November 2022–August 2023), the study enrolled 40 women aged 18–49. The intervention group received six to eight individualized weekly sessions (60 min each) delivered by trained counselors using a standardized EX-PLISSIT protocol refined with expert feedback, while the control group received standard care only. Outcomes were assessed with the Female Sexual Function Index (FSFI) and the New Sexual Satisfaction Scale (NSSS). Randomization was performed using stratified block permutation by an independent statistician to ensure balance for disability (EDSS) and fatigue (FSS) status. The intervention group showed greater improvements in both sexual function and satisfaction compared with controls (<i>p</i> &lt; 0.05). Mean FSFI scores increased from 21.25 ± 2.54 to 24.00 ± 1.74, versus 21.37 ± 3.09 to 21.47 ± 2.56 in controls, between-group differences most apparent for lubrication, orgasm, and satisfaction subscales. Similarly, NSSS scores improved from 71.55 ± 16.07 to 83.88 ± 7.42, while controls remained similar (76.05 ± 16.59 to 76.68 ± 10.10). Despite improvements, mean FSFI totals remained below the clinical cutoff of 26.55, suggesting residual dysfunction. EX-PLISSIT counseling was associated with improvements in sexual health among women with MS in a small, single-center trial. The findings suggest that structured counseling can be integrated into routine care, with high acceptability. Training healthcare professionals and expanding access to sexual counseling in chronic disease management are strongly recommended. Structured counseling may be feasibly integrated into neurology care, but larger, multi center trials are needed to confirm effectiveness and durability.</p><p><?qj left?><?noindent??><i>Trial registration</i> ClinicalTrials.gov&#xa0;NCT06199219.</p>

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Enhancing Sexual Health in Multiple Sclerosis: A Randomized Controlled Trial of EX-PLISSIT Counseling

  • 期刊论文

  • 发表日期：

    2025年12月23日

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  • Vesile Koçak,
  • Ayyüce Tuba Koçak,
  • Selda Arslan,
  • Ali Ulvi Uca

摘要

Sexual dysfunction affects up to 90% of women with multiple sclerosis (MS) and remains underaddressed due to limited knowledge, lack of privacy in consultations, and societal stigma, underscoring the need for effective interventions. This randomized controlled trial evaluated whether a sexual counseling intervention based on the Extended Permission, Limited Information, Specific Suggestions, and Intensive Therapy (EX-PLISSIT) model was associated with improvements in sexual function and satisfaction among women with MS in Turkey. Conducted at a university hospital in Turkey (November 2022–August 2023), the study enrolled 40 women aged 18–49. The intervention group received six to eight individualized weekly sessions (60 min each) delivered by trained counselors using a standardized EX-PLISSIT protocol refined with expert feedback, while the control group received standard care only. Outcomes were assessed with the Female Sexual Function Index (FSFI) and the New Sexual Satisfaction Scale (NSSS). Randomization was performed using stratified block permutation by an independent statistician to ensure balance for disability (EDSS) and fatigue (FSS) status. The intervention group showed greater improvements in both sexual function and satisfaction compared with controls (p < 0.05). Mean FSFI scores increased from 21.25 ± 2.54 to 24.00 ± 1.74, versus 21.37 ± 3.09 to 21.47 ± 2.56 in controls, between-group differences most apparent for lubrication, orgasm, and satisfaction subscales. Similarly, NSSS scores improved from 71.55 ± 16.07 to 83.88 ± 7.42, while controls remained similar (76.05 ± 16.59 to 76.68 ± 10.10). Despite improvements, mean FSFI totals remained below the clinical cutoff of 26.55, suggesting residual dysfunction. EX-PLISSIT counseling was associated with improvements in sexual health among women with MS in a small, single-center trial. The findings suggest that structured counseling can be integrated into routine care, with high acceptability. Training healthcare professionals and expanding access to sexual counseling in chronic disease management are strongly recommended. Structured counseling may be feasibly integrated into neurology care, but larger, multi center trials are needed to confirm effectiveness and durability.

Trial registration ClinicalTrials.gov NCT06199219.