title: Sexual dysfunction in women with multiple sclerosis: Dimensions and contributory factors.
abstract: BACKGROUND
  Sexual dysfunction (SD) is a common reported problem in patients with multiple sclerosis (MS).
  
  
  OBJECTIVE
  to examine frequency and distribution of SD dimensions and to determine whether SD is related to various clinical and demographic variables in female patients.
  
  
  METHODS
  A total of 271 MS women (age: 19-50 years) participated in this cross-sectional study. We used a structured demographic and clinical interview and Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19). Disability was rated by Expanded Disability Status Score (EDSS).
  
  
  RESULTS
  63.5% (n = 173) of women had SD included 142 (52.4%) women with primary SD, 102 (37.5%) women with secondary SD and 120 (41%) women with tertiary SD. The most common SD-related complaint was orgasmic problem (41.2%). Women with primary SD were significantly older and had higher EDSS score. No significant relationship was found between primary SD and disease duration. Fatigue (OR = 2.69, 95% CI: 1.352-5.385, P = 0.005), memory and concentration complaints (OR = 1.915, 95% CI: 1.034-3.546, P = 0.039) and some of urinary symptoms such as frequency (OR = 2.108, 95% CI: 1.015-4.375, P = 0.045) were seem to be the significant predictors. Fatigue was also found to be the most powerful predicting factor for tertiary SD (OR = 2.793, 95% CI: 1.358-5.744 P = 0.005).
  
  
  CONCLUSIONS
  SD, a common multifactorial problem among MS women, can arise at any time during the disease and with any level of disability. However, we found relationships between SD and some of clinical variables and symptoms. Understanding these relationships would help us to develop practical approach and treatment for SD.
authors.affiliation: Department of Neurology, Isfahan University of Medical Sciences, Ayatolah Kashani Hospital, Medical Faculty, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Fereshteh
authors.initials: F
authors.lastname: Ashtari
authors.affiliation: Department of Neurology, Isfahan University of Medical Sciences, Ayatolah Kashani Hospital, Medical Faculty, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Rezvani
authors.affiliation: Department of Psychiatric, Isfahan University of Medical Sciences, Ayatolah Kashani Hospital, Medical Faculty, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Afshar
keywords: Female sexual dysfunction; MSISQ-19; multiple sclerosis