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Female sexuality in multiple sclerosis: the multidimensional nature of the problem and the intervention

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Abstract:

Bronner G, Elran E, Golomb J, Korczyn AD. Female sexuality in multiple sclerosis: the multidimensional nature of the problem and the intervention.

Acta Neurol Scand: 2010: 121: 289–301.

© 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard.

Female sexual functioning is a complex process involving physiological, psychosocial and interpersonal factors. Sexual dysfunction (SD) is frequent (40–74%) among women with multiple sclerosis (MS), reflecting neurological dysfunction, psychological factors, depression, side effects of medications and physical manifestations of the disease, such as fatigue and muscle weakness. A conceptual model for sexual problems in MS characterizes three levels. Primary SD includes impaired libido, lubrication, and orgasm. Secondary SD is composed of limiting sexual expressions due to physical manifestations. Tertiary SD results from psychological, emotional, social, and cultural aspects. Sexual problems cause distress and may affect the family bond. Practical suggestions on initiation of discussion of sexual issues for MS patients are included in this review. Assessment and treatment of sexual problems should combine medical and psychosexual approaches and begin early after MS diagnosis. Intervention can be done by recognizing sexual needs, educating and providing information, by letting patients express their difficulties and referring them to specialists and other information resources.

Keywords: female sexual dysfunction; intercourse–outercourse approach; multidimentional intervention; multiple sclerosis; physician role; talking about sex; treatment

Document Type: Research Article

DOI: https://doi.org/10.1111/j.1600-0404.2009.01314.x

Affiliations: 1: Sexual Medicine Center, Department of Urology, Sheba Medical Center, Tel Hashomer, Israel 2: Department of Urology, Sheba Medical Center, Tel Hashomer, Israel 3: Sieratzki Chair of Neurology, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

Publication date: 2010-05-01

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