To perform a systematic review and meta-analysis to estimate the point prevalence of sexual dysfunction (SD) in multiple sclerosis (MS) patients, total and stratified by gender.

Although SD is commonly observed in MS patients, it is frequently overlooked in the clinical setting. There remains limited consensus on the actual prevalence and determinants of SD in patients with MS.

Relevant literature databases were searched for studies reporting on the prevalence of SD in MS between January 1977 and January 2015. Random-effects models were used to pool reported prevalence of SD in MS. Stratified meta-analysis and meta-regression were used to estimate differences due to study-level characteristics. Heterogeneity was assessed using DerSimonian and Laird’s Q-test and the I²-index. Sensitivity analyses were performed to assess studies deemed to have low risk-of-bias (ROB) according to a modified version of the Newcastle-Ottawa Scale. 

6135 studies were retrieved, of which 43 met inclusion and exclusion criteria. The overall pooled weighted prevalence of SD was 58% (6635/14538 individuals, 95% CI, 52-64%), 63% in women (95% CI, 53-74%; n=27 studies), and 62% in men (95% CI, 54-69%; n=24 studies). There was significant between-study heterogeneity (all MS: Q= 1608.63, I2 = 97.39%; women: Q= 1608.63, I2 = 97.39%; men: Q=302.34, I2 = 92.39%, p<0.01 for all). Pooled meta-regression did not indicate a significant association of SD prevalence with age, disability (Expanded Disability Status Scale), duration of disease, or proportion with relapsing-remitting disease. A sensitivity analysis including only studies deemed to have low ROB did not result in a significant difference in the pooled prevalence of SD (55%, 95% CI, 48-62%, p=0.95).

SD is highly prevalent in MS patients, across the spectrum of disease. These data highlight the need for increased recognition of SD within MS clinical practice and evidence-based approaches to address this facet of the disease.