F-3-01-03
SEXUAL FUNCTION IN WOMEN WITH ADVANCED MULTIPLE SCLEROSIS
Birgitta Hulter, P O Lundberg (Sexology Unit and Department of Rehabilitation Medicine, Uppsala University, Uppsala, Sweden)
Purpose: To relate experienced changes in sexual functions in women with multiple sclerosis to locations of afflicted neurological structures and to social factors.
Method: Forty seven women, aged 21 to 55 years were interviewed focusing the women's medical, sexological and social case histories. They were neurologically examined and their neurological impairment was rated by an expanded disability status scale (EDSS).
Result: Median age was 46 years, and median EDSS was 6.5. Eighty-three per cent were dependent on others for personal and/or instrumental ADL. Sixty per cent of the women reported decreased sexual desire, 36 % decreased lubrication and 38 % diminished orgasmic capacity. The sexual dysfunctions correlated to neurological symptoms from the sacral segments, and to age and amenorrhoea. The experienced lost effects of sexual stimulation techniques was one sign of a decrease in sexual sensory nervous functions. Cohabitation correlated to lower EDSS scores. Problems with sexual functions were more frequent in women with lower EDSS scores.
Conclusion: The decreased sexual interest and orgasm are much the same as in previous studies. The problems of lubrication are greater. Overall negative sexual changes were significantly more often reported by women with lower scores in EDSS. There is high risk of divorce among the more disabled women. Hardly any of the women had been asked by her regular physician about her sexuality.
F-3-01-04
Early Sexual Rehabilitation Program after TBI
R. Aloni, M. Cohen, N. Rosenthul, O. Keren, Z. Groswasser (National Center for Sexual Rehab. and TBI Unit Lowenstein Rehab. Center, Ranana, Israel)
The Early Sexual Intervention Program (ESIP) train the staff in the ward, intervene with the survivors and their families or partner. It includes information regarding the effect of TBI on the sexual function, counseling, group therapy, outside social activities, as well as couple and family therapy. It is a tailor made therapy program for each survivor although provided in group settings. The program is planed for the period of time when survivors are still in the rehabilitation center, for the purpose of maintaining their sexual function and intimate abilities.
The above program is based on a survey which took place in the Traumatic Brain Injury Ward. It included 46 patient who were interviewed twice during the first 6 months of their hospitalization. This group provided information about the sexual function of TBI survivors soon after the injury.
A survey of 30 professionals who work with survivors of TBI provided information regarding the late sexual complains of survivors of TBI and the effective therapeutic methods with this special population.
A survey of the literature of related field provided additional therapeutic methods addressing sexual dysfunction. The information from the three sources was integrated into a prevention intervention program.
