Sexual Dysfunction in Women with Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis

Sexual dysfunction (SD) is a common and significant complication in neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS), though it is often neglected and undertreated. We aimed to compare female sexual dysfunction in patients with NMOSD and MS, and investigate the association between clinical characteristics and SD. In this cross-sectional study, 36 patients with NMOSD and 312 MS patients who visited the MS clinic of Kashani Hospital were recruited. Sexual dysfunction was evaluated using the Iranian version of the Female Sexual Function Index (FSFI) questionnaire. Fatigue, depression, and anxiety were also assessed by fatigue severity score (FSS), Beck depression inventory-II (BDI-II), and Hamilton anxiety rating scale (HAM-A), respectively. Sexual dysfunction was presented in 75% of NMOSD and 63.5% of MS patients ( P = 0.127). The most frequent SD problem in both NMOSD and MS was dysfunctional arousal (50% vs. 48.1%, P = 0.855). The frequency and mean score of sexual pain dysfunction in NMOSD patients was higher than MS, but it did not remain significant in the adjusted model. No statistically significant differences in the frequency and mean scores of other SD subdomains were detected. In the univariate model, only fatigue was associated with the presence of SD in NMOSD. In MS patients, depression was an independent risk factor of SD in the multivariate model. Our results confirm that SD is a common problem in female NMOSD and MS patients. Further longitudinal studies are needed to evaluate sexual dysfunction and its risk factors in NMOSD. In addition, attention to the management of depression and fatigue could be positively effective on sexual dysfunction in patients with NMOSD and MS.