Sexual disorders in men with multiple sclerosis: Evaluation and management
| Autor: | J.-M. Soler, P. Denys, J.-G. Previnaire, G. Lecourt |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Male
medicine.medical_specialty Disease Sclérose en plaques Dysfonction érectile Multiple sclerosis Ejaculation dysfunction Injections intracaverneuses medicine Humans Orthopedics and Sports Medicine Erectile dysfunction Spasticity Intensive care medicine Penile vibratory stimulation Depression (differential diagnoses) Inhibiteurs de la phosphodiéstrase business.industry Rehabilitation medicine.disease Intracavernous injections Sexual Dysfunction Physiological Midodrine Sexual dysfunction Dysfonction éjaculatoire Phosphodiesterase inhibitors Stimulation vibratoire pénienne Physical therapy Anxiety medicine.symptom business Psychosocial |
| Zdroj: | Annals of Physical and Rehabilitation Medicine. (5):329-336 |
| ISSN: | 1877-0657 |
| DOI: | 10.1016/j.rehab.2014.05.002 |
| Popis: | Sexual dysfunction (SD) is a common feature of men with multiple sclerosis. SD is often unrecognized as patients and physicians are reluctant to discuss these problems. Rates of symptoms range from 50% to 90% and include erectile dysfunction, ejaculatory dysfunction, orgasmic dysfunction and reduced libido. SD can arise at any stage of the disease, even without severe disability. While erectile dysfunction is thought to be related to impairment of the pathways in the spinal cord, fatigue, spasticity, bladder and bowel dysfunction, and pain, contribute to SD. Psychosocial and cultural issues also need evaluating, and include depression, performance anxiety, lowered self-esteem. A comprehensive assessment of all theses aspects must be taken into account. Erectile dysfunction can be treated with phosphodiesterase inhibitors and intracavernous injections, with good efficacy. Ejaculatory dysfunction is managed through penile vibratory stimulation and midodrine. Concerning fertility issues, the effects of or immunomodulating drugs on semen quality are largely unknown, whereas many immunosuppressive therapies have a negative effect on semen quality that may be definitive. Advanced methods of assisted reproduction may sometimes be the only option for conception. Physicians’ awareness of this problem may help to bring about appropriate treatments, and improve the quality of life for these patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|