Sexual Dysfunction in People with Multiple Sclerosis: Associated Factors and Effects on Quality of Life

Sexual dysfunction (SD) is a common symptom in people with multiple sclerosis (PwMS), often underestimated and with a significant impact on health-related quality of life (HrQoL). We analyzed the prevalence of SD in PwMS and its association with demographic, clinical and psychological variables. This cross-sectional study included 86 PwMS. SD and its impact on quality of life (QoL) were assessed using validated questionnaires, the Patient-Determined Disease Steps (PDDS), Modified Fatigue Impact Scale, Beck Depression Inventory-II and EQ-5D-5L for HrQoL. Sexual function was evaluated using the Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 (MSISQ-15). Of the participants, 68.6% were women, with a mean age of 44 years. The most frequent phenotype was relapsing–remitting (83,7%). The prevalence of SD was 34.9%, without differences between sexes. The mean MSISQ-15 score was 39.8, indicating a moderate impact of MS on sexual function. SD was associated with older age, higher disability (PDDS ≥ 3), fatigue, depression and lower HrQoL. No associations were found with educational level, marital status, sexual orientation, disease-modifying treatment and phenotype. SD in PwMS has a multifactorial nature and is mainly influenced by depression, fatigue and disability. Given its impact on quality of life, it is essential to address it systematically in clinical practice, using specific tools such as the MSISQ-15 and promoting comprehensive care for PwMS.