May 28, 2019
Last year, scientists reported that almost two-thirds of people with multiple sclerosis (MS) experience sexual challenges, with the most common problems being loss of libido, orgasm difficulties, and trouble with arousal (vaginal lubrication and erections).
While this rate is high, it doesn’t mean that people with MS can’t enjoy intimacy. But understanding the challenges, staying patient, and making adjustments will go a long way in keeping sexual relationships strong.
How does MS cause sexual problems? Here are some of the mechanisms:
- Poor message transmission. MS is a central nervous system disorder that attacks the myelin sheath, the coating that protects nerve cells. The result is a disconnect between the brain and other body parts, including organs involved with sexual function. For example, a man with MS might receive sexual stimulation (such as an erotic image or touch), but his brain might not “get the message” to start an erection. Similarly, a woman’s vagina might not lubricate because it doesn’t “know” about sexual stimuli. For some people, MS leads to decreased – or increased – genital sensation. In some cases, touch might become painful.
- Depression and anxiety. An illness like MS takes a toll on one’s mental health as well. It can be hard to plan for the future, and people may miss doing things they used to do. They might also worry about their partner’s feelings and reaction to the situation. Communication between partners can break down. Together, these factors can diminish libido and make it more difficult to become aroused.
- Incontinence. Some people with MS feel nervous about having urinary accidents, especially during sex.
- Fatigue. With MS, it’s not unusual to feel too tired for sex.
- Spasticity and muscle weakness. Trouble controlling muscle movements or feeling weak in the muscles may make some sexual activities difficult.
Problems for Women
In November 2018, a study in the Journal of Sexual Medicine provided some insight on how extensive sexual dysfunction is among women with MS. Researchers looked at data from nine other studies on MS and female sexuality. Overall, almost 1,500 women – roughly half with MS – were involved.
In the analysis, women with MS were almost twice as likely to have sexual problems than women who didn’t have MS. Trouble with arousal, lubrication, desire, orgasm, and pain were more common in women with MS. They also tended to have lower sexual satisfaction.
Problems for Men
Erectile dysfunction (ED) is a common problem for men with MS. Erections might not be firm enough for sex, or they might not occur at all.
Fortunately, men with ED have a number of treatment options:
Men might also experience trouble with ejaculation.
If you or your partner is struggling with MS and intimacy, consider these options:
- See your doctor. As about treatments for sexual issues. For example, the solution for poor vaginal lubrication might be an over-the-counter product. And as noted above, there are several ways to treat erectile dysfunction. Many people feel awkward discussing their sex life with their doctor. But remember, your doctor is there to help you.
- Seek other professional help. Seeing a counselor or sex therapist, especially one who works with people with MS, can give you some new ideas to try in the bedroom. He or she can also help you cope with any depression, anxiety, or relationship conflict you might be experiencing. (Learn more about sex therapy here.)
- Talk to your partner. Have an honest, open conversation with your partner about any changes in your sexual relationship and how you’re feeling about them. He or she might be feeling the same way but be hesitant to bring it up. Work as a team to keep your relationship on track, emotionally and sexually.
- Plan for sex. For people with MS, it isn’t always possible to have sex at the spur of the moment. But you can plan for romance and intimacy. Figure out when you and your partner can have time to yourselves to relax and enjoy being together. It might not be as spontaneous, but having that time to look forward to can be just as exciting.
- Take your time. If it takes you longer to become fully aroused or to climax, that’s okay. Just enjoy the journey and don’t worry about timetables.
- Experiment. You might need to try other types of sexual stimulation because what worked for years might not be as effective. Now is a great time to try something new. That “something new” could be a new type of touch, different sexual positions, oral sex, the use of sex toys like vibrators, sex at a different time of day, or sex in a new location. Be open to new ideas.
Vann, Madeline R., MPH
“How to Have a Healthy Sex Life When You Have Multiple Sclerosis”
(Last updated: December 21, 2016)
International Society for Sexual Medicine
“How might multiple sclerosis affect a person sexually?”
The Journal of Sexual Medicine
Zhao, Shankun MD, et al.
“Association Between Multiple Sclerosis and Risk of Female Sexual Dysfunction: A Systematic Review and Meta-Analysis”
(Full-text. Published online: November 1, 2018)
National Multiple Sclerosis Society
“About Two-Third of MS Patients Have Sexual Problems”
“Maintaining Intimacy With Multiple Sclerosis”
(Reviewed: April 24, 2016)