Sexual dysfunction in migraine patients who receive preventive treatment: identification by means of two screening tests
*Correspondencia: Dr. Ángel Luis Guerrero Peral. Servicio de Neurología. Hospital Clínico Universitario de Valladolid. Ramón y Cajal, 3. E-47005 Valladolid.
E-mail: gueneurol@gmail.com
Introduction: Sexual dysfunctions are one of the most important problems affecting sexual health and are associated with low levels of quality of life.
Aim: To assess the sexual functioning in migraine patients and the sexual dysfunction that can be attributed to its preventive treatment.
Patients and methods: The patients attended in the headache units of two general hospitals who visited for the first time after being prescribed preventive treatment. They answered the Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) and the Psychotropic-Related Sexual Dysfunction Questionnaire (SALSEX).
Results: The sample used in the study consisted of 79 patients (17 males, 62 females) aged 37.6 ± 9.1 years (range: 19-57 years), 31 (39.2%) of them with chronic migraine. As preventive treatment, 23 (29.1%) received beta blockers; 42 (53.2%) neuromodulators; 8 (10.1%), calcium antagonists; and 6 (7.6%), antidepressants. The MGH-SFQ detected diminished overall sexual satisfaction that was at least moderate in 24 patients (30.4%). SALSEX showed changes in sexual functioning that was attributable to the preventive treatment in 36 cases (45.5%), which only exceptionally appeared spontaneously. In patients with at least moderate dysfunction on the MGH-SFQ, the mean ages at the time of testing, the number of days with pain per month and the excessive use of medication for their symptoms were all higher (53.3% versus 46.7%; p = 0.03).
Conclusions: Simple sexual dysfunction screening tests often detect sexual dysfunctions in patients with migraine on preventive treatment and changes in their sex life that can be attributed to these drugs.
Objetivo Evaluar la función sexual en pacientes migrañosos y la disfunción sexual atribuible al tratamiento preventivo.
Pacientes y métodos Pacientes atendidos en las consultas de cefaleas de dos hospitales generales que acudían a la primera visita tras prescripción de un preventivo. Respondieron al cuestionario de funcionamiento sexual del Hospital General de Massachusetts (MGH-SFQ) y al cuestionario de disfunción sexual secundaria a psicofármacos (SALSEX).
Resultados Muestra de 79 pacientes (17 varones, 62 mujeres), de 37,6 ± 9,1 años (rango: 19-57 años), 31 (39,2%) de ellos con migraña crónica. Como tratamiento preventivo, 23 (29,1%) recibían betabloqueantes; 42 (53,2%), neuromoduladores; 8 (10,1%), antagonistas del calcio, y 6 (7,6%), antidepresivos. El MGH-SFQ detectó en 24 pacientes (30,4%) disminución al menos moderada de satisfacción sexual global. El SALSEX mostró cambio de la función sexual atribuible al tratamiento preventivo en 36 casos (45,5%), sólo excepcionalmente manifestada de forma espontánea. En pacientes con disfunción al menos moderada en el MGH-SFQ, eran significativamente mayores la edad media en el momento de la inclusión, el número de días de dolor al mes y el uso excesivo de medicación sintomática (53,3% frente a 46,7%; p = 0,03).
Conclusión La disfunción sexual evaluada con sencillos tests de cribado detecta con frecuencia disfunción sexual en pacientes migrañosos en tratamiento preventivo y cambios en su vida sexual atribuibles a estos fármacos.