Reproductive Health, Sexuality, and Pregnancy Decision-Making in Women with Multiple Sclerosis: A Qualitative Study

Abstract

ObjectivesMultiple sclerosis is a chronic neurological condition frequently diagnosed during women's reproductive years and may influence sexuality, reproductive health, and pregnancy decision-making. This study aimed to explore the lived experiences of women with multiple sclerosis regarding sexual health, family planning, and pregnancy decisions.MethodsA qualitative descriptive design was employed. In-depth, face-to-face individual interviews were conducted with 30 women aged 18-45 years who had been diagnosed with multiple sclerosis and were receiving care at a Training and Research Hospital's multiple sclerosis outpatient clinic. Participants were recruited using purposive sampling. Data were analyzed using inductive thematic analysis.ResultsThe mean age of the participants was 31.90 +/- 6.91 years, and the mean duration of illness was 7.36 +/- 5.97 years. The thematic analysis revealed six main themes and sixteen sub-themes: (1) lack of knowledge, (2) need for education and counseling, (3) effect of multiple sclerosis on fertility intentions, (4) emotional and psychological reactions, (5) sexual and women's health issues, and (6) family planning methods and preferences. Participants described significant challenges related to sexual functioning, uncertainty about pregnancy outcomes, and limited access to individualized counseling services.ConclusionsWomen with multiple sclerosis experience complex and interconnected sexual and reproductive health needs. Findings highlight substantial gaps in counseling and sexuality-focused support. A holistic, patient-centered, and sexuality-informed care approach is essential to support informed reproductive decision-making in women with multiple sclerosis.