Objective:

To assess the prevalence of sexual dysfunction among Algerian patients with multiple sclerosis (MS) and explore its association with psychological factors, including anxiety, depression, and fatigue, as well as clinical variables such as disability levels. The study aims to provide insights into the impact of sexual dysfunction on patient well-being and emphasize the need for a multidisciplinary approach to improve the quality of care.

Background:

Multiple Sclerosis (MS) encompasses a spectrum of neurological symptoms, including
motor, sensory, and cognitive impairments, as well as less discussed areas like sexual
dysfunction. Sexual health complications, though underreported, have a profound effect
on patients' quality of life. This study aims to explore the prevalence of sexual dysfunction among MS patients in Algeria and identify key contributing factors.
Multiple Sclerosis (MS) presents a variety of symptoms, including motor, sensory, visual
disturbances, as well as cognitive, sexual, and psychiatric dysfunctions. Genital disorders are
common and underreported complications that significantly impact the quality of life.
Our objective in this study is to determine the prevalence of sexual dysfunction in patients with
multiple sclerosis (MS) and its associated factors

Design/Methods:

We conducted a cross-sectional study on 147 patients (101 women and 46 men) diagnosed with multiple sclerosis (MS) according to the 2017 McDonald diagnostic criteria, all over 18 years of age and followed at the neurology department of Sidi Bel Abbes University Hospital in western Algeria.
Patients' demographic data were collected, including gender, age, disease type, and disease
duration. Disability levels, depression, anxiety, fatigue, as well as cognitive and genital disorders, were assessed using the Expanded Disability Status Scale (EDSS), the 9-Hole Peg Test (9-HPT), the 25-Foot Walk Test (25-FW), Hospital Anxiety and Depression Scale, Fatigue Scale for Motor and Cognitive Functions (FSMCF), Symbol Digit Modalities Test (SDMT), Female Sexual Function Index, and International Index of Erectile Function for male patients.
Statistical analysis was performed using SPSS 20, and comparisons between groups were
conducted using appropriate statistical tests (Chi-squared test) with a significance threshold set at p < 0.05.

Results:

The study included 147 patients (101 women and 46 men) diagnosed with MS. Key findings showed:

1. Prevalence of Sexual Dysfunction:

45 out of 101 women (44.6%) reported sexual dysfunction.

35 out of 46 men (76%) experienced erectile dysfunction, with varying severity (mild: 8, moderate: 16, severe: 11 cases).

2. Psychological Correlations:

Significant associations were found between sexual dysfunction and anxiety, depression, and fatigue in both genders (p < 0.05).

Women with MS experienced sexual dysfunction more frequently when anxiety, depression, and fatigue were present.

In men, erectile dysfunction severity also correlated significantly with these psychological factors.

3. Lack of Correlation with Physical and Cognitive Disability:

No significant relationships were found between sexual dysfunction and patient demographics, motor disabilities, or cognitive impairments, as measured by the 25-Foot Walk Test (25-FW) and the 9-Hole Peg Test (9-HPT).

Conclusions:

The findings from this study suggest that sexual dysfunction in individuals with MS is strongly
linked to psychological parameters such as anxiety, depression, and fatigue, rather than the
physical progression of the disease. These results advocate for the inclusion of mental health
evaluations and sexual health discussions as routine aspects of patient care to enhance the overall quality of life in this population.
Our results indicate that sexual dysfunction in multiple sclerosis is primarily influenced by
psychological factors rather than disease severity, thus highlighting the importance of comprehensive management. This should include psychological evaluation and the systematic
exploration of genital disorders in women and erectile dysfunction in men as part of clinical
follow-up.
These findings underscore the necessity of a multidisciplinary approach to improve the quality of life for patients with multiple sclerosis.