Gender Differences in Sexual Dysfunction: An Examination of Primary, Secondary, Tertiary Subgroup Reporting on the MSISQ-15

Background: Sexual dysfunction (SD) is common in individuals with MS with an estimated prevalence of 73%. SD in MS can be divided into three categories: primary, secondary, and tertiary sexual dysfunction (PSD, SSD, TSD) characterized by MS related neurologic changes with direct implications on sexuality, physical changes with indirect effects on sexual behavior, and psychosocial factors that negatively impact sexual functioning, respectively. Past research has demonstrated gender differences related to the impact of MS on sexual functioning as well as differences in the efficacy of treatments. Investigation of gender differences in the reporting of the SD subgroupings, may provide insight into how these problems can best be differentially addressed.

Objectives: Using the Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 (MSISQ-15) and a large sample, we aimed to assess whether gender differences exist in the reporting of PSD, SSD, and TSD symptoms.

Methods: The study sample consists of respondents to the North American Research Committee on Multiple Sclerosis Registry’s (NARCOMS) survey via Internet and mail. Only respondents who provided complete responses to the survey were included in the analysis (1,405 of 2,237 male respondents [62.8%]; 4,262 of 7,010 female respondents [60.8%]). A total of 5,667 participants were included in the final sample for the current analysis. Data in the analysis included gender and self-reported responses to the MSISQ-15. An Independent Samples Mann-Whitney U Test and linear mixed effects model (LMEM) were conducted using SPSS 25.0 to assess whether gender difference exist in the three categories of SD.

Results: The LMEM analysis showed gender was associated with the MSISQ-15 subscales (p<.001). The Mann-Whitney U-Test found that gender was significantly associated with TSD (p< .001). Men reported a greater amount of TSD symptoms (M=12.29, SE=.119) compared to women (M=10.73, SE=.069). There was no significant gender difference in PSD (p=.625) and SSD (p= .387).

Conclusions: Men reported a greater number of TSD symptoms compared to women, suggesting that men are more likely to experience MS-related emotional and psychosocial issues, which in turn negatively impact their sexual functioning. Future treatment and interventions for SD in MS should incorporate aims to target these factors.