Multiple Sclerosis and Sexual Dysfunction

Multiple sclerosis (MS) is the most frequent chronic neurological disorder in young adults. Sexual dysfunction (SD) is a common complaint in people with MS, although often unreported or underassessed, and represents a significant burden of disease. Prevalence of SD in MS is higher than in the general population, with reported prevalence of SD of 17–95% in women and 31–92% in men. Etiology of the altered sexual function in this disease has been grouped as primary causes (those related with the direct neurological damage caused by the demyelinating lesions affecting the neural pathways), secondary causes (factors associated with MS symptoms such as spasticity, pain, bladder, and bowel dysfunction), and tertiary causes (mood disorders, interpersonal difficulties, body image concerns, fear of rejection, cognitive impairment). Evaluation of SD in people with MS requires a comprehensive sexual clinical history and examination, and different questionnaires have been validated in MS patients for the detection of SD. Some treatments, preventive strategies, sexual counseling, and a multidisciplinary approach might manage SD in this disease, so it is necessary to increase the focus on these aspects of the illness when assessing patients.