Sex-based Differences in Alterations of Sexual Function and Relationship Adjustment in People With Multiple Sclerosis: A Cross-sectional Study

BACKGROUND: Multiple sclerosis (MS) is a neurological disease that manifests differently in men and women, including variations in clinical progression and symptoms. Despite the relevance of these differences, research exploring disparities in sexuality and relationships remains limited. Therefore, this study aimed to identify differences between men and women in alterations in sexual function and relationship adjustment in a Spanish sample of people with MS. METHODS: A descriptive cross-sectional study was conducted involving 208 adults recruited through 13 Spanish MS associations. An electronic form was used to collect sociodemographic and sexuality-related variables. The Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 and the Dyadic Adjustment Scale-13 were also included in the data collection process. RESULTS: Men with MS reported greater concerns about sexually satisfying their partner ( P < 0.001) and more frequent feelings of sexual insecurity ( P = 0.001) than women. Differences in sexual function were also observed in physiological aspects, with erectile dysfunction being more prevalent in men than vaginal lubrication difficulties in women ( P = 0.031). Regarding relationship adjustment, no significant differences were identified ( P = 0.816). However, a significant correlation was found between relationship adjustment and alterations in sexual function in men ( P = 0.038). CONCLUSIONS: The results of this study point to meaningful differences between men and women with MS in how sexual function is experienced, with men reporting greater concerns related to both physiological (erectile dysfunction) and psychological (worries about satisfying their partner and insecurity) difficulties. Regarding relationship adjustment, overall levels were similar between groups; however, poorer sexual function was significantly associated with worse adjustment only among men. These specific differences should be taken into account when addressing sexuality in clinical care, as considering these disparities may contribute to more comprehensive, personalized, and effective interventions for people with MS.