Assessment of sexual function in women with neurological disorders: A review

Abstract

Background: Although the rehabilitation of sexual function has been identified as a top priority among women presenting neurological conditions, sexual function is rarely assessed in this clinical group.

Objectives: To review published assessment tools of sexual dysfunction in women with neurological conditions including multiple sclerosis (MS), spinal cord injury (SCI), Parkinson disease, stroke, traumatic brain injury.

Methods: A systematic literature review was conducted with Medline via PubMed, PubMed Central, and Medline databases.

Results: There are three reliable methods to assess sexual dysfunctions in women with neurological conditions: physiological assessments of reflexes and perineal sensitivity testing, self-reporting questionnaires on sexual function and sexual satisfaction, and electrophysiological assessments. Physiological assessments of sacral and thoracolumbar reflexes have mainly been conducted among women with SCI. When performed, they reveal the existence of a psychogenic and/or reflex sexual potential in those women. Other forms of physiological assessments include vulvar sensitivity testing in women with SCI, quantitative sensory testing and pudendal somatosensory evoked potentials in MS populations. A few validated self-reporting measures are also available to assess sexual potential and sexual satisfaction, although mostly in women with SCI and MS.

Conclusion: Despite high prevalence rates and important clinical implications, sexual dysfunction is not systematically assessed in women presenting various neurological conditions. Several well-validated tools exist for such assessments, which could be used for sexual rehabilitation in these patients. The implementation of systematic assessments of sexual potential is feasible and renewed efforts should be made to do so in clinical practice.

Keywords: Electrophysiology; Multiple sclerosis; Parkinson; Physiological assessment; Sexual questionnaires; Spinal cord injury; Stroke; Traumatic brain injury; Women; neurological conditions.