Sexual dysfunction in females with multiple sclerosis: quantitative sensory testing.
OBJECTIVE
Female sexual dysfunction (FSD) is highly prevalent (45-74%) in multiple sclerosis (MS) patients. Quantitative sensory testing (QST) has recently been used to assess normal neural function of the female genitalia. In this study we used QST for assessment of the genital neural function of female MS patients.


METHODS
We examined 41 female MS patients aged 21-56, with 10 years median disease duration. Each patient had a neurological examination, and evaluation of sexual function (SF) by both questionnaire and a focused interview. QST was performed at the clitoris and vagina for temperature and vibratory stimuli, by method of limits.


RESULTS
By questionnaire, 25 patients (61%) had FSD; the most common complaints were decreased libido (61%) and orgasmic disturbances (54%). Sensory deficit was very common--significant correlations were found between high sensory thresholds and FSD parameters; the most significant correlation was between clitoral vibratory sensation and orgasmic dysfunction (r = 0.423, P = 0.006). Another interesting significant association was found between cerebellar deficit and orgasmic dysfunction (P = 0.0012).


CONCLUSIONS
This study suggests that QST of the genitalia, specifically clitoral vibration, may be a useful test for detecting sexual dysfunction in MS patients, and supports an important role of the cerebellum in SF.
Gruenwald
Ilan
I
Neuro-Urology Unit, Rambam Medical Center, Haifa, Israel. ilgr@netvision.net.il
Vardi
Yoram
Y
Gartman
Irena
I
Juven
Elizabeth
E
Sprecher
Elliot
E
Yarnitsky
David
D
Miller
Ariel
A
D000328:Adult; D002531:Cerebellum / Q000502:physiology; D002987:Clitoris / Q000502:physiology; D003943:Diagnostic Techniques, Neurological; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007989:Libido; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications*; D012680:Sensitivity and Specificity; D012684:Sensory Thresholds; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis* / Q000209:etiology*; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis / Q000209:etiology; D011795:Surveys and Questionnaires; D013696:Temperature; D014732:Vibration