The Effect of Sexual Counseling with the PLISSIT Model on Sexual Function and Sexual Quality of Life in Women with Multiple Sclerosis: A Randomized Controlled Trial.

Abstract

Sexual dysfunction is common in women with MS, but evidence on long-term effects of PLISSIT counseling is limited. This randomized trial evaluated its 12-month effects on sexual function and quality of life. Eighty-six women aged 18-45 years were randomized to counseling (n = 43) or control (n = 43). Sixty-three participants completed all follow-up assessments and were included in the complete-case analysis (counseling, n = 31; control, n = 32). The intervention comprised four counseling sessions over four weeks. Outcomes were assessed at baseline and 3, 6, and 12 months using the Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 (MSISQ-15), Sexual Quality of Life Questionnaire-Female (SQOL-F), and self-reported weekly intercourse frequency. Significant group × time interactions occurred for MSISQ-15 total (p = 0.006), primary sexual dysfunction (p = 0.029), and secondary sexual dysfunction (p < 0.001), although Bonferroni comparisons were nonsignificant in the counseling group (all p > 0.05). SQOL-F and intercourse frequency showed significant time effects (both p < 0.001). SQOL-F improved from baseline to 6 months and from 6 to 12 months (both p < 0.001). Intercourse frequency was higher with counseling at 6 (p < 0.001) and 12 months (p = 0.004). PLISSIT-based counseling was associated with different longitudinal patterns and greater sexual activity; however, improvements in sexual quality of life cannot be attributed solely to the intervention.