Sexual Dysfunction in Multiple Sclerosis: Prevalence, Risk Factors, and Impact on Quality of Life in a Large Cohort Study

Background Sexual dysfunction (SD) is a prevalent but underreported symptom in people with multiple sclerosis (pwMS), significantly affecting quality of life (QoL). Despite its clinical relevance, SD is often overlooked during routine care. This study aimed to determine the prevalence of SD, identify associated risk factors, assess its impact on depression and QoL, and explore help-seeking behaviors among pwMS. Methods A cross-sectional study was conducted with 504 pwMS followed at a tertiary MS clinic between November 2023 and May 2024. Data on demographics, disease characteristics, and medications were collected. The Arizona Sexual Experiences Scale (ASEX) was used to assess SD, the Beck Depression Inventory (BDI) for depression, and the Short Form-12 (SF-12) for QoL. EDSS scores were used to evaluate disability. Statistical analyses included t-tests, ANOVA, chi-square, and correlation analyses, with significance set at p < 0.05. Results SD was identified in 69.0% of patients (73.9% of women, 57.6% of men). SD was significantly associated with female gender (p = 0.001), older age (p = 0.006), higher EDSS scores (p = 0.046), and increased depression levels (r = 0.38). SF-12 scores were significantly lower among those with SD (p < 0.001). No significant associations were found between SD and MS type, disease duration, or type of disease-modifying therapy. Only 16.9% of patients with SD reported seeking medical or psychological support. Conclusion SD is highly prevalent among pwMS and is closely linked to age, disability, depression, and reduced QoL. Despite this burden, most patients do not seek help. We recommend routine screening and multidisciplinary management approaches are essential for addressing SD in this population.