Identifying barriers to help-seeking for sexual dysfunction in multiple sclerosis

J Neurol. 2018 Dec;265(12):2789-2802. doi: 10.1007/s00415-018-9064-8. Epub 2018 Sep 19.

Abstract

Background: Sexual dysfunction (SD) is common in multiple sclerosis (MS), however, under-reported.

Objective: The aim of this study was to identify barriers faced by patients with MS and healthcare professionals (HCPs) in discussing SD.

Methods: This was a two-part prospective study carried out at a tertiary care centre. Patients with MS were surveyed using a 29-item questionnaire and SD was assessed using the MSISQ and ASEX questionnaires; depression screened with PHQ-2. HCPs were surveyed using a 23-item questionnaire.

Results: Seventy four patients (mean age 42.4 ± 10.7, 54 females) and 98 HCPs (mean age 45.8 ± 8.9, 90 females) participated. SD was significant, with primary (36.4%), secondary (27%) and tertiary (29.8%) contributory factors. Commonest barriers reported by patients were dominance of neurological symptoms (N = 30, 40.5%), presence of family or friends (N = 28, 37.8%), and not being asked (N = 25, 33.8%), while HCPs reported presence of family or friends (N = 34, 34.7%), lack of knowledge about SD (N = 30, 30.6%), and inadequate time during the consultation (N = 27, 27.6%).

Conclusions: Barriers to discussing SD are similar between patients and HCPs. The most common barriers are addressable through modifications in the clinic environment, raising awareness and providing training opportunities.

Keywords: Barriers; Healthcare professionals; Help-seeking; Multiple sclerosis; Questionnaires; Sexual dysfunction.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Family
  • Female
  • Friends
  • Health Communication
  • Health Personnel / psychology
  • Health Services Accessibility*
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications*
  • Multiple Sclerosis / psychology*
  • Multiple Sclerosis / therapy
  • Prospective Studies
  • Sexual Dysfunction, Physiological / etiology*
  • Sexual Dysfunction, Physiological / psychology*
  • Sexual Dysfunction, Physiological / therapy*
  • Young Adult