MINI REVIEW article
Front. Cell Dev. Biol.
Sec. Molecular and Cellular Reproduction
Exploring the interconnectedness of multiple sclerosis and erectile dysfunction: mechanisms and management strategies
Provisionally accepted
- Department of Urology, First Affiliated Hospital of Jilin University, Changchun, China
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Erectile dysfunction (ED) is common in men with multiple sclerosis (MS) and arises from convergent neurogenic, autonomic, vascular, inflammatory, and psychosocial pathways. We synthesize epidemiologic prevalence and risk data on ED in MS, map mechanistic pathways linking central and spinal lesions, autonomic–endothelial imbalance, and psychosocial modulators to ED phenotypes, and provide a stage-based care algorithm integrating neuro-urological testing and psycho-sexological support. Across more than 30 studies, pooled ED prevalence in men with MS is approximately 50%, with higher odds at greater disability and with co-existing lower urinary tract symptom (LUTS) and depression. Phosphodiesterase-5 inhibitors (PDE5i) are commonly used as first-line pharmacologic therapy, although data specific to MS remain limited and individual response can vary. Device-, injection-, neuromodulation-, and prosthesis-based options offer escalation pathways. Evidence quality varies and residual confounding and detection bias remain possible.
Keywords: Multiple Sclerosis, Erectile Dysfunction, neurogenic bladder, Urodynamics, Neuromodulation
Received: 21 Oct 2025; Accepted: 27 Nov 2025.
Copyright: © 2025 Yuan, Zhang, Cao, Wang and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bo Yuan
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.