[Anticholinergics do not affect the sexual function in women diagnosed with multiple sclerosis]

Aim: Determine if the initiation of an anticholinergic treatment affects the sexual function in women diagnosed with multiple sclerosis (MS).

Methods: It was a single-centre prospective open label study on 18 women affected by MS, with a clinical overactive bladder syndrome, and examined before and after anticholinergic treatment. Several variables were studied before and after treatment: the total anticholinergic load (Anticholinergic Drug Scale [ADS]), the Female Sexual Function Index, the Urinary Symptom Profile (USP) and functional status (EDSS, MIF). Quantitative variables were analyzed using Student's test.

Results: Eighteen women with an average age of 48.3 years old (±10.7 years), average EDSS of 4.6 (±1.5) were examined before and after anticholinergic treatment (solifenacin and trospium). Anticholinergic load at baseline was 0.33 (±0.5) and 3.44 (±0.70) after treatment (P<0.0001). The initiation of an anticholinergic treatment allowed a significant improvement on the subscore OAB USP (10.25±4.3 to 6.22±3 P=0.01). No significant impacts of the anticholinergic load on the Female Sexual Function Index (FSFI) score (18.9±10.8 to 21.2±10.8 P=0.06) and sub-items lubrification (3.6±2.2 to 3.7±2.2 P=0.6), pain (3.6±2.5 to 4.2±2.3 P=0.4), desire (3±1.2 to 3±1.5 P=0.7), orgasm (2.7±2.1 to 3±2.4 P=0.4), satisfaction (3.9± to 4±2 p=0.9), arousal (2.9±2 to 3.3±1.8 P=0.8) was evidenced.

Conclusion: In this limited series of "naive" patients with MS, no impact of anticholinergic therapy on vaginal lubrication or sexual quality was observed.

Level of evidence: 4.