Multiple Sclerosis (MS) is an inflammatory auto-immunological disease of the central nervous system. Its most important pathological feature is the destruction of the myelin sheath. It is one of the leading causes of disability in young adults, typically affecting individuals between the ages of 20 and 40, with a higher prevalence in women. The etiology of MS is multifactorial, involving both genetic predispositions and environmental factors such as viral infections [1]. When considering the quality of life of patients with MS, the realm of sexuality is often overlooked. Sexual function is a complex process that requires the cooperation of multiple body systems, including the nervous, hormonal, and vascular systems. In addition to direct neurological damage, the psychological consequences of living with MS, such as depression, anxiety, and low self-esteem, can further impact sexual function and intimate relationships [2,3]. 
The objective of the study was to evaluate the prevalence and severity of sexual dysfunctions in MS patients. A comprehensive understanding of these data may elucidate the magnitude and complexity of the issue, highlighting the necessity for the development of multidisciplinary treatment protocols.

A sample of 185 individuals diagnosed with MS, comprising both men and women, was surveyed with informed consent. An anonymous written questionnaire was used to collect data on the extent of the issue and participants' perceptions of current treatment methods. The questionnaire included questions about the type of disease, functional abilities, symptoms related to sexual dysfunction, and knowledge of pelvic disorder diagnosis and treatment. The data were analyzed using descriptive statistics, and qualitative responses were examined through narrative analysis.

The study highlights the significant impact of sexual dysfunction in individuals with MS, affecting 83.8% of participants, including 87.4% of females and 73.8% of males, at different stages of disease progression. Specifically, 57.9% of participants reported a reduction in sexual needs compared to pre-diagnosis levels. Furthermore, 50.8% of individuals experienced varying levels of orgasmic dysfunction, while 46.5% reported a lack of pleasure during intercourse. Additionally, 43.3% expressed reluctance and fear toward sexual activity. Knowledge about sexual problems related to chronic illness among the participants was relatively high, with 50.9% being aware of treatment methods and 49.8% understanding the etiology of these disorders.  Despite the high prevalence of sexual dysfunction and a high level of knowledge, only a small percentage of respondents disclosed these concerns to their physicians and physiotherapists. Furthermore, there is a notable gap in patient education regarding sexual health from healthcare professionals.

The study's findings support the hypothesis that sexual dysfunction impacts a significant proportion of individuals with MS. This issue may often go unreported, leading to a lack of appropriate treatment, despite a reasonably adequate level of knowledge about the dysfunction. These results indicate that the extent of the problem warrants the integration of sexuality-focused protocols into treatment and rehabilitation practices in the MS population.

Sexual dysfunction affects a large number of patients with MS. The scale of this issue is still underestimated and requires further research on a larger scale. However, there is a clear need to establish an interdisciplinary team dedicated to the treatment of sexual dysfunction in MS.

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Dobrakowski, P.; Machowska-Majchrzak, A.; Labuz-Roszak, B.; Niewiadomska, E.; Pierzchala, K. Sexual Satisfaction in Fully Ambulatory People with Multiple Sclerosis: Does Disability Matter? Behav. Neurol. 2020, 2020, 8857516. https://doi.org/10.1155/2020/8857516. PMID: 33101540; PMCID: PMC7569446.
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