title: Sexual dysfunction levels in iranian women suffering from multiple sclerosis.
abstract: OBJECTIVE
  Sexual dysfunction (SD) is a common complaint in women who suffer from Multiple Sclerosis (MS), which has been categorized in three levels (primary, secondary, and tertiary) in previous studies. This study was conducted to assess the prevalence of sexual dysfunction (SD) at each level, and to identify associated factors and their impacts on SD in married women who suffer from Multiple Sclerosis. This study was conducted in Iran where the cultural barriers are recognized as important challenges in sexual function.
  
  
  METHODS
  This is a single center study that was carried out in Iran MS Society. A total of 182 married women with MS (aged between 18 and 49 years) were participated in this study. We used the structured and self-report questionnaires including Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), together with socio-demographic and clinical questions, such as Expanded Disability Status Scale (EDSS), Fatigue Severity Scale (FSS) and Beck Depression Inventory (BDI) to collect the data. Pearson's correlation coefficients and analysis of variance (ANOVA) were performed for data analysis.
  
  
  RESULTS
  Sexual dysfunction was reported in 149 patients (81.9%), including 136 (74.7%) women with primary SD, 70 (38.5%) women with secondary SD and 81 (44.5%) with tertiary SD. The most prevalent symptoms at each level of SD were orgasmic problems, spasticity and worries about sexual satisfaction of partners, respectively. The total score of MSISQ-19 was associated with education (P<0.001), income status (P<0.001), age (P<0.001), number of children (P<0.05), marriage duration (P<0.05), EDSS score (P<0.01), fatigue (P<0.01), depression (P<0.001), length of disease (P<0.01) and length of drug medication therapies (P<0.01).
  
  
  CONCLUSIONS
  According to this study, sexual dysfunction, especially primary SD was one of the most prevalent problems among women with MS. In addition, this study showed a complex and multifactorial nature for SD among these women. In order to provide an appropriate treatment and management of SD, associated factors and their impacts should be considered.
authors.affiliation: Nursing Management Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Nahid
authors.initials: N
authors.lastname: Dehghan-Nayeri
authors.affiliation: Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Khakbazan
authors.affiliation: Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: faezeh.ghafoori@yahoo.com.
authors.forename: Faezeh
authors.initials: F
authors.lastname: Ghafoori
authors.affiliation: Neurology and Neuroscience Research and Clinical Department, Royan Institute, Tehran, Iran.
authors.forename: Seyed Massood
authors.initials: SM
authors.lastname: Nabavi
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003469:Culture; D004185:Disability Evaluation; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D057566:Self Report; D012720:Severity of Illness Index; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
keywords: Iran; Multiple sclerosis; Reproductive-age women; Sexual dysfunction