Multiple sclerosis (MS) is a neurological condition which is characterized by the degeneration and inflammation of the central nervous system. MS is the most common cause of disability in young adults and is twice as common in women as men. Roughly 40-85% of female MS patients have reported some incidence of female sexual dysfunction (FSD), which may be due to direct damage to the neural pathways by MS, symptoms of MS (spasticity, bowel issues, general weakness, etc.), or psychological disabilities caused by MS. Both FSD and MS can have a significant impact on overall quality of life, although the FSD may not be discussed in clinical settings for any number of reasons.
In order to assess the prevalence of FSD in MS patients and explore the relationship between FSD- and MS-related clinical and sociodemographic factors, researchers collected survey data from 83 patients with MS over a 5-month period in 2019. Patients had an average age of around 41, and were interviewed by researchers in private, 30-minute sessions. 15.7% of patients were post-menopausal. Survey questions included those from a variety of tools used to assess MS-related symptoms like fatigue, sleep disturbances, depression, and overall quality of life (specific to MS), as well as the Female Sexual Function Index (FSFI), which assesses female sexual function, in which a low score indicates FSD.
Female Sexual Function and MS Symptoms
Based on results from the FSFI portion of questions, 72.3% of patient responses indicated FSD. Compared to the MS Quality of Life portion of questions, FSFI scores were found to have a positive correlation. This means that as FSFI scores improved, so did quality of life. Researchers say that this data, in tandem with other studies, emphasizes that FSD is a widespread problem amongst female MS patients. When compared with patients facing other chronic illnesses, FSFI scores were still significantly lower in the MS group, suggesting that MS affects FSD at higher rates than other chronic illnesses.
When comparing FSFI scores to the other sections of the survey, researchers found worse sexual function or more FSD was associated with higher likelihood of fatigue, depression and poorer sleep quality. They say this means one of two things. One, as these symptoms increase in severity, the burden of MS increases, impacting other symptoms such as FSD. And two, the secondary impact of these symptoms impacts FSD. It is known that sleep issues like insomnia and fatigue can exacerbate FSD.
Clinical factors such as age, disease duration, and functional status may impact FSD in MS patients as well. For example, menopausal women in general struggle with FSD due to hormonal changes and may experience further difficulty when these challenges are combined with MS symptoms.
Conclusion
The most significant factors contributing to FSD in female MS patients, according to researchers, are age, disease duration, fatigue, depression, and sleep quality. Despite several limitations, such as potential bias due to researchers being present during questioning, this study is one of few that evaluates factors associated with FSD in females with MS. With this information, researchers hope to encourage healthcare providers and MS patients to discuss sexual functioning, in turn, expanding knowledge in the field and fostering more informative care.
References:
Yeni, K., Tulek, Z., & Terzi, M. (2025). Sexual dysfunction in female patients with multiple sclerosis: Relationship with functional status, fatigue, depression, sleep quality, and quality of life. The Journal of Sexual Medicine, 22(3), 464–472. https://doi.org/10.1093/jsxmed/qdaf015
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