Identifying barriers to help-seeking for sexual dysfunction in multiple sclerosis

Background Sexual dysfunction (SD) is common in multiple sclerosis (MS), however, under-reported. Objective The aim of this study was to identify barriers faced by patients with MS and healthcare professionals (HCPs) in discussing SD. Methods This was a two-part prospective study carried out at a tertiary care centre. Patients with MS were surveyed using a 29-item questionnaire and SD was assessed using the MSISQ and ASEX questionnaires; depression screened with PHQ-2. HCPs were surveyed using a 23-item questionnaire. Results Seventy four patients (mean age 42.4 ± 10.7, 54 females) and 98 HCPs (mean age 45.8 ± 8.9, 90 females) participated. SD was significant, with primary (36.4%), secondary (27%) and tertiary (29.8%) contributory factors. Commonest barriers reported by patients were dominance of neurological symptoms ( N = 30, 40.5%), presence of family or friends ( N = 28, 37.8%), and not being asked ( N = 25, 33.8%), while HCPs reported presence of family or friends ( N = 34, 34.7%), lack of knowledge about SD ( N = 30, 30.6%), and inadequate time during the consultation ( N = 27, 27.6%). Conclusions Barriers to discussing SD are similar between patients and HCPs. The most common barriers are addressable through modifications in the clinic environment, raising awareness and providing training opportunities.