Evaluation of sex hormones (FSH, Estrogen and Testostrone) changes during follicular and luteal phases and sexual dysfunction in women with Multiple Sclerosis

Multiple sclerosis is the most common cause of progressive neurological disability in young adults who may be sexually active. MS patients experience high levels of sexual dysfunction with hypoactive sexual behavior and abnormalities in hypothalamus-pituitary-gonad (HPG) axis. In present study, we aimed to evaluate sexual dysfunctions and correlation between serum levels of sex hormones during menstrual cycle and the sexual response of women with MS. A total of 30 female MS patients with relapsing-remitting MS (RRMS) aged from 20 to 40 years (average=31.46) divided according to expanded disability status scale into 3 groups (EDSS<1.5, EDSS=1.5-3, EDSS>3) and 30 female age-matched healthy control (average=32.09) subjects were included into the study. The female sexual function index (FSFI) questionnaire was used to determine sexual dysfunctions. Serum follicle stimulating hormone (FSH), oestradiol and testosterone were checked in follicular and luteal phases of menstrual cycle. We observed significant hormonal abnormalities consisted of decreased testosterone levels in follicular and luteal phases, decreased oestradiol and FSH levels in luteal phases and increased oestradiol levels in follicular phases during menstrual cycle. FSFI scores in MS patients including desire, arousal, orgasm and lubrication were significantly lower than the healthy group. The results showed that MS disease can affect sex hormone levels in follicular and luteal phases. In this study we observed a positive correlation between serum hormone levels and some domains of FSFI. Thus serum levels of sex hormones can affect sexual functions in MS patients.