Sexual dysfunction and gender conformity in a Multiple Sclerosis population
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Sexual dysfunction (SD) is a common yet often overlooked symptom of Multiple Sclerosis (MS) that impacts approximately 40-80% of the MS population. Estimates of SD among women with MS range between 40 and 80% and 50 to 90% in men. Men and women with MS experience lower levels of sexual activity, sexual esteem (confidence in experiencing sexuality in a satisfying and enjoyable way), sexual satisfaction, and relationship satisfaction than people in the general population. The aim of this research is to gain a better understanding of the predictors of tertiary (psychosocial) sexual dysfunction in MS, particularly if one's conformity to their traditional gender norms (masculinity and femininity) can have an impact on their experience of sexual dysfunction. Previous research has shown an association between conformity to gender norms, psychological well-being and sexual dysfunction in non-MS populations. Fifty-eight women and a pilot study of fourteen men reported their perceptions of their level of masculinity and femininity based on traditional gender norms and rated their sexual dysfunction , level of disability, and emotional distress (measured by the Hospital Anxiety and Depression Scale (HADS)). Level of conformity to masculine/feminine norms did not predict level of sexual dysfunction. In both samples, men (r=.69, p<.01) and women (r =.32, p<.05) reported increased disability with advanced age. Advanced age in women was related to lower levels of emotional distress (HADS) (r=.040, p<.01). Women who reported more severe disability were also more likely to report tertiary sexual dysfunction (r=.38, p<.0l). In the overall sample, one's level of emotional distress mediated the relationship between disability and tertiary SD, b=0.13, CI [.003, .397]. However, when repeated in the female sample only, this effect was not significant but did display a trend towards significant mediation (b=.10, 95% CI [-.02, .42]). These findings indicate that there are still many unknown predictors of sexual dysfunction in MS but that women who are more disabled are at higher risk of tertiary sexual dysfunction. This can be helpful in identifying patients and creating interventions for individuals most at risk to experience sexual dysfunction.