Document Type: Original Article
Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
Background: In chronic illnesses, sexual dysfunction (SD) is one of the most prevalent complaints. Sexual self-efficacy (SSE) is an individual’s beliefs about his/her ability to perform an effective sexual function and be favorable to their partner. The aim of the present study was to assess SSE and sexual function in women with multiple sclerosis (MS).
Methods: This cross-sectional study was carried out in 2019 on 260 married women referring to the MS clinic and MS society of Khorasan-Razavi in Mashhad, Iran. The research population was selected using convenience sampling. The Sexual Self-Efficacy Questionnaire (SSEQ), Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), and the Female Sexual Function Index (FSFI) were completed by the participants who had the inclusion criteria. The collected data were analyzed using descriptive statistics and Spearman's rank correlation coefficient in SPSS software.
Results: The participants had a mean age of 35.2 ± 8.4 years and their mean duration of MS was 4.46 ± 3.71 years. The findings showed a negative correlation between SSE and SD (r = -0.606; P = 0.001) and a positive correlation between SSE and sexual function (r = 0.644; P = 0.001). Moreover, MSISQ-19 and FSFI scores supported each other (r = -0.675; P = 0.001).
Conclusion: SD is prevalent among women with MS. Moreover, sexual function is substantially associated with SSE in these women.
- Crayton H, Heyman RA, Rossman HS. A multimodal approach to managing the symptoms of multiple sclerosis. Neurology 2004; 63(11 Suppl 5): S12-S18.
- Payamani F, Nazari AA, Noktehdan H, Ghadiriyan F, Karami K. Complementary therapy in patients with multiple sclerosis. Iran J Nurs 2012; 25(77): 12-20. [In Persian].
- Tepavcevic DK, Kostic J, Basuroski ID, Stojsavljevic N, Pekmezovic T, Drulovic J. The impact of sexual dysfunction on the quality of life measured by MSQoL-54 in patients with multiple sclerosis. Mult Scler 2008; 14(8): 1131-6.
- Sanders AS, Foley FW, LaRocca NG, Zemon V. The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19). Sex Disabil 2000; 18(1): 3-26.
- Foley FW, Beier M. Assessment and treatment of sexual dysfunction in multiple sclerosis. National Multiple Sclerosis Society [Online]. [cited 2006]; Available from: URL: https://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures Clinical_Bulletin_Sexual-Dysfunction-in-MS.pdf
- Ghandehari K, Riasi HR, Nourian A, Boroumand AR. Prevalence of multiple sclerosis in north east of Iran. Mult Scler 2010; 16(12): 1525-6.
- Azami M, YektaKooshali MH, Shohani M, Khorshidi A, Mahmudi L. Epidemiology of multiple sclerosis in Iran: A systematic review and meta-analysis. PLoS One 2019; 14(4): e0214738.
- Etemadifar M, Abtahi SH. Multiple sclerosis in Isfahan, Iran: Past, present and future. Int J Prev Med 2012; 3(5): 301-2.
- Sadock BJ, Sadock VA, Ruiz P, Kaplan HI. Kaplan and Sadock's comprehensive textbook of psychiatry. New York, NY: Lippincott Williams and Wilkins; 2009.
- Steinke EE, Wright DW, Chung ML, Moser DK. Sexual self-concept, anxiety, and self efficacy predict sexual activity in heart failure and healthy elders. Heart Lung 2008; 37(5): 323-33.
- Assarzadeh R, Bostani Khalesi Z, Jafarzadeh-Kenarsari F. Sexual self-efficacy and associated factors: A review. Shiraz E-Med J 2019; 20(11): e87537.
- Bartnik P, Wielgos A, Kacperczyk J, Pisarz K, Szymusik I, Podlecka-Pietowska A, et al. Sexual dysfunction in female patients with relapsing-remitting multiple sclerosis. Brain Behav 2017; 7(6): e00699.
- Qaderi K, Merghati Khoei E. Female sexual problems in multiple sclerosis and its association with quality of life. Nurs Midwifery J 2013; 11(7): 526-33. [In Persian].
- Kessler TM, Fowler CJ, Panicker JN. Sexual dysfunction in multiple sclerosis. Expert Rev Neurother 2009; 9(3): 341-50.
- Gruenwald I, Vardi Y, Gartman I, Juven E, Sprecher E, Yarnitsky D, et al. Sexual dysfunction in females with multiple sclerosis: Quantitative sensory testing. Mult Scler 2007; 13(1): 95-105.
- Dehghan-Nayeri N, Khakbazan Z, Ghafoori F, Nabavi SM. Sexual dysfunction levels in Iranian women suffering from multiple sclerosis. Mult Scler Relat Disord 2017; 12: 49-53.
- Somaye A, Gity O, Hamidreza AM. Comparison of sexual self-efficacy and sexual function in fertile and infertile women referred to health centers in Mashhad in 1392. Pajoohande 2014; 19(3): 131-6. [In Persian].
- Sampson RJ, Laub JH, Wimer C. Does marriage reduce crime? A counterfactual approach to within-individual causal effects. Criminology 2006; 44(3): 465-508.
- Guo ZN, He SY, Zhang HL, Wu J, Yang Y. Multiple sclerosis and sexual dysfunction. Asian J Androl 2012; 14(4): 530-5.
- Celik DB, Poyraz EC, Bingol A, Idiman E, Ozakbas S, Kaya D. Sexual dysfunction in multiple sclerosis: Gender differences. J Neurol Sci 2013; 324(1-2): 17-20.
- Kisic-Tepavcevic D, Pekmezovic T, Trajkovic G, Stojsavljevic N, Dujmovic I, Mesaros S, et al. Sexual dysfunction in multiple sclerosis: A 6-year follow-up study. J Neurol Sci 2015; 358(1-2): 317-23.
- Janghorban R, Latifnejad RR, Taghipour A, Abbasi M, Lottes I. The shadow of silence on the sexual rights of married Iranian women. Biomed Res Int 2015; 2015: 520827.
- Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011; 69(2): 292-302.
- Akkus Y, Duru G. Problems and factors affecting the sexual lives of patients with multiple sclerosis living in Turkey. Sex Disabil 2011; 29(1): 55-63.
- Demirkiran M, Sarica Y, Uguz S, Yerdelen D, Aslan K. Multiple sclerosis patients with and without sexual dysfunction: Are there any differences? Mult Scler 2006; 12(2): 209-14.
- Mohammadi K, Rahnama P, Tabar SM, Montazeri A. Validation of the Persian version of Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19). Payesh Health Monit 2014; 13(5): 601-7. [In Persian].
- Fakhri A, Mohammadi Zeidi I, Pakpour Haji Agha A, Morshedi H, Mohammad Jafari R, Ghalambor Dezfooli F. Psychometric properties of Iranian version of Female Sexual Function Index. Jundishapur Sci Med J 2011; 10(4):
345-54. [In Peersian].
- Dasgupta R, Wiseman OJ, Kanabar G, Fowler CJ, Mikol D. Efficacy of sildenafil in the treatment of female sexual dysfunction due to multiple sclerosis. J Urol 2004; 171(3): 1189-93.
- Fakhri A, Morshedi H, Soleymanian A. Psychometric properties of Iranian version of Male Sexual Function Index. Jundishapur Sci Med J 2014; 12(6): 655-63.
- Vaziri S, Lotfi Kashani F. Study of factor structure, reliability and validity of the sexual self efficacy questionnaire. Thoughts and Behavior in Clinical Psychology 2013; 8(29): 47-56. [In Persian].
- Askari F, Ghajarzadeh M, Jalilian R, Azimi A, Togha M, Sahraian MA, et al. Comparison of sexual dysfunction in women with migraine and multiple sclerosis (MS). Maedica (Bucur) 2016; 11(1): 44-7.
- Roya A, Barzandig, Niloofar S, Jahdi, Esmat M, Roghaiyeh N, et al. Sexual dysfunction in Iranian Azeri women with multiple sclerosis: Levels and correlates. Crescent Journal of Medical and Biological Science 2019; 6(3): 381-7.
- Mohammadi K, Rahnama P, Mohseni SM, Sahraian MA, Montazeri A. Determinants of sexual dysfunction in women with multiple sclerosis. BMC Neurol 2013; 13: 83.
- Rahnama P, Mohammadi K, Mohseni SM, Mohammaditabar S. Impact of affected functional systems on primary sexual dysfunction in women with multiple sclerosis. J Mazandaran Univ Med Sci 2017; 26(146): 100-108. [In Persian]
- Merghati-Khoei E, Qaderi K, Amini L, Korte JE. Sexual problems among women with multiple sclerosis. J Neurol Sci 2021; 331(1-2): 81-5.
- Ashtari F, Rezvani R, Afshar H. Sexual dysfunction in women with multiple sclerosis: Dimensions and contributory factors. J Res Med Sci 2014; 19(3): 228-33.
- Calabro RS, Bramanti P. Sexual dysfunction in multiple sclerosis: Still a neglected problem? Disabil Rehabil 2014; 36(17): 1483.
- Tudor KI, Eames S, Haslam C, Chataway J, Liechti MD, Panicker JN. Identifying barriers to help-seeking for sexual dysfunction in multiple sclerosis. J Neurol 2018; 265(12): 2789-802.
- Ghasemi V, Simbar M, Ozgoli G, Nabavi SM, Alavi MH. Prevalence, dimensions, and predictor factors of sexual dysfunction in women of Iran Multiple Sclerosis Society: A cross-sectional study. Neurol Sci 2020; 41(5): 1105-13.
- Borello-France D, Leng W, O'Leary M, Xavier M, Erickson J, Chancellor MB, et al. Bladder and sexual function among women with multiple sclerosis. Mult Scler 2004; 10(4): 455-61.
- Scheepe JR, Alamyar M, Pastoor H, Hintzen RQ, Blok BF. Female sexual dysfunction in multiple sclerosis: Results of a survey among Dutch urologists and patients. Neurourol Urodyn 2017; 36(1): 116-20.
- Kooranian F, Foroughipour M, Khosravi A. Association of disability with urinary and sexual dysfunction in patients with multiple sclerosis. Iran J Obstet Gynecol Infertil 2018; 20(11): 39-46. [In Persian].
- Amsel R. Sexual self-efficacy scale for female functioning. In: Fisher TD, editor. Handbook of Sexuality-Related Measures. New York, NY: Routledge; 2011. p. 551-4.
- Kafaei Atrian M, Mohebbi Dehnavi Z, Kamali Z. The relationship between sexual self-efficacy and sexual function in married women. J Midwifery Reprod Health 2019; 7(2): 1703-11.
- Reissing ED, Laliberte GM, Davis HJ. Young women's sexual adjustment: The role of sexual self-schema, sexual self-efficacy, sexual aversion and body attitudes. Can J Hum Sex 2005; 14(3): 77-85.
- Powwattana A, Ramasoota P. Differences of sexual behavior predictors between sexually active and nonactive female adolescents in congested communities, Bangkok metropolis. J Med Assoc Thai 2008; 91(4): 542-50.
- Hensel DJ, Fortenberry JD, O'Sullivan LF, Orr DP. The developmental association of sexual self-concept with sexual behavior among adolescent women. J Adolesc 2011; 34(4): 675-84.
- Potki R, Ziaei T, Faramarzi M, Moosazadeh M, Shahhosseini Z. Bio-psycho-social factors affecting sexual self-concept: A systematic review. Electron Physician 2017; 9(9): 5172-8.
- Ziaei T, Farahmand Rad H, Rezaei Aval M, Roshandel G. The relationship between sexual self-concept and sexual function in women of reproductive age referred to health centers in Gorgan, North East of Iran. J Midwifery Reprod Health 2017; 5(3): 969-77.
- Abarbanel J, Rabinerson D. Sexual dysfunction in women. Harefuah 2004; 143(6): 426-31, 462, 461. [In Hebrew].
- Bronner G, Elran E, Golomb J, Korczyn AD. Female sexuality in multiple sclerosis: the multidimensional nature of the problem and the intervention. Acta Neurol Scand 2010; 121(5): 289-301.
- Lew-Starowicz M, Rola R. Prevalence of sexual dysfunctions among women with multiple sclerosis. Sex Disabil 2013; 31(2): 141-53.
- Zorzon M, Zivadinov R, Monti BL, Moretti R, De Masi R, Nasuelli D, et al. Sexual dysfunction in multiple sclerosis: A 2-year follow-up study. J Neurol Sci 2001; 187(1-2): 1-5.
- Stenager E, Stenager EN, Jensen K. Sexual aspects of multiple sclerosis. Semin Neurol 1992; 12(2): 120-4.
- Gott M, Galena E, Hinchliff S, Elford H. "Opening a can of worms": GP and practice nurse barriers to talking about sexual health in primary care. Fam Pract 2004; 21(5): 528-36.
- Delaney KE, Donovan J. Multiple sclerosis and sexual dysfunction: A need for further education and interdisciplinary care. NeuroRehabilitation 2017; 41(2): 317-29.
- Panjalipour S, Bostani Khalesi Z, Mirhaghjoo SN. Iranian female adolescents’ reproductive health needs: A systematic review. International Journal of Women's Health and Reproduction Sciences 2018; 6(3): 226-32.
- Brotto LA, Bitzer J, Laan E, Leiblum S, Luria M. Women's sexual desire and arousal disorders. J Sex Med 2010; 7(1 Pt 2): 586-614.