A Pilot Study on Sex Hormones and Cognition in Men with Multiple Sclerosis

Abstract

Objective: The presence of sexual dysfunction in male patients further exacerbates the adverse impressions of multiple sclerosis (MS) on the quality of life. The goal of our study was to evaluate the relationship between sex hormons and disease severity, sexual dysfunction, and cognition in male MS patients. Materials and Methods: Twenty-eight MS patients and 14 age- and education-matched healthy controls were included in the study. To assess the cognitive status: California verbal learning test, symbol digit modalities test, revised brief visuospatial memory test, trail-making test, and to evaluate sexual function, male sexuel healt questinore (MSHQ) and international index of erectile function (IIEF) scales were used. Serum Anti-Mullerian hormone level, follicle-stimulating hormone, luteinizing hormone, and total testosterone levels were evaluated. Results: Serum testosterone levels were significantly lower in the MS group than in the healthy group (4.28±1.20 and 4.50±2.24, respectively; p=0.012). Sexual functions were evaluated using the MSHQ and IIEF, and the MSHQ-ejaculation function scores were statistically significantly lower in the patient group than in the control group (p=0.014). Erectile function was assessed using the IIEF. Erectile dysfunction (ED) was detected in 11 (39%) patients, and four patients could not provide semen analysis specimens due to severe ED. Brief visuospatial memory test and California Verbal Learning test scores were statistically significantly lower in the ED group than in non-ED group (p=0.008, p=0.008, and p=0.026). Conclusion: The importance of sexual functions and hormones during MS has been demonstrated by both laboratory and cognitive tests.

Keywords

• multiple sclerosis
• testosterone
• cognition