The Differential Impact of Sexual Dysfunction on HRQoL in Men and Women with MS

Background: Sexual dysfunction (SD) impacts an estimated 73% of the MS population. SD in MS is categorized by primary, secondary, and tertiary dysfunctions (PSD, SSD, PSD). PSD refers to neurological changes with direct effects on sexual functioning; SSD involves physical MS-related changes indirectly related to sexuality; and TSD is the result of psychosocial factors. Research suggests that SD is strongly related to perception of both physical and mental health-related quality of life (HrQoL) in MS. Exploring how gender differences moderate the impact of PSD, SSD, and TSD on HRQoL may increase our understanding and treatment of SD in MS.

Objectives: Use the Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 (MSISQ-15) to examine whether gender moderates the impact of PSD, SSD, TSD on physical and mental HrQoL.

Methods: The sample consists of respondents to the North American Research Committee on Multiple Sclerosis Registry’s (NARCOMS) survey. A total of 5,667 participants were included in the final sample (1,405 males and 4,262 females). Self-report data from the MSISQ-15, the mental and physical subscales of the self-report SF-12 Health Survey (MCS-12 and PCS-12), and the Patient Determined Disease Steps (PDDS) were examined. Six hierarchical linear regressions (HLR) were conducted using SPSS 25.0 to examine the association between gender and PSD, SSD, and TSD on HQoL. MCS-12 and PCS-12 were entered as the outcome variables. Age, employment, and disability were entered in block 1. Gender, PSD, SSD, and TSD were entered in block 2. The interaction between gender and SD category was entered in block 3.

Results: PSD (b = -.147, p<.001) predicted PCS-12; gender was not significant (p>.05). Gender moderated the effect between PSD and PCS-12 (b=­ .084, p<.001). PSD predicted MCS-12 (b = -.281, p<.001); gender and the moderation were not significant. SSD (b = -.511, p<.001) predicted PCS-12; gender was not significant. Gender moderated the effect between SSD and PCS-12 (b=­ .127, p<.001). SSD predicted MCS-12 (b = -.914, p<.001); gender and the moderation were not significant. Gender (b = 0.020, p<.001) and TSD (b = -.132, p<.05) predicted PCS-12. Gender moderated the effect of TSD on PCS-12 (b=.083, p<.001). TSD predicted MCS-12 (b = -.132, p<.05); gender and the moderation were not significant.

Conclusions: Gender moderated the relationship between PSD, SSD, TSD and PCS-12. Gender did not moderate the relationship between the MCS-12 on PSD, SSD, TSD.