Sexual Function in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis Publisher Pubmed



Mj Yazdan Panah Mohammad JAVAD ; S Oraee SOROUSH ; M Fekri MEHRA ; P Saberian PARSA ; S Afshin SAHRA ; S Vaheb SAEED ; V Shaygannejad VAHID ; O Mirmosayyeb OMID
Source: Journal of Sexual Medicine Published:2025

Abstract

Introduction Sexual dysfunction is prevalent in people with multiple sclerosis (PwMS) and considerably affects their quality of life. Although sexual function (SF) is crucial in PwMS, its relationship with other characteristics remains insufficiently understood. Objective This review aimed to consolidate the evidence comparing SF between PwMS and healthy controls (HCs) and to explore its correlation with various demographic, clinical, and psychological factors. Methods The PubMed/MEDLINE, Embase, Scopus, and Web of Science databases were systematically searched up to July 28, 2024, to identify studies comparing SF between PwMS and HCs or assess its correlation with various demographic, clinical, and psychological characteristics. Random effects models were used in R software version 4.4.0 to estimate the pooled standardized mean difference (SMD) and pooled correlations, with their 95% CIs as the effect size metrics. Results In this review, 61 studies comprising 16 266 PwMS were included. The meta-analysis indicated that SF was significantly reduced in PwMS compared to HCs, with females with MS (FwMS) showing lower Female Sexual Function Index scores (SMD: -0.41, 95% CI, -0.61 to -0.20, P <. 0001) and males with MS (MwMS) demonstrating reduced International Index of Erectile Function scores (SMD: -0.77, 95% CI, -1.32 to -0.22, P <. 01). Correlation analyses highlighted associations between reduced SF and higher Expanded Disability Status Scale (EDSS), longer disease duration, and depression in gender-aggregated analyses. Reduced SF was also found to correlate with older age, higher EDSS scores, depression, and fatigue in FwMS. Conclusion The findings of the included studies indicated that SF is lower in PwMS compared to HCs and is influenced by age, disease duration, depression, and the EDSS. Further studies on the effects of comorbidities, medications, and MS classification on the SF of PwMS are warranted. © 2025 Elsevier B.V., All rights reserved.