Multiple Sclerosis: How to Have a Healthy Sex Life

Multiple sclerosis (MS), like many other chronic medical conditions, can affect every aspect of a person’s life, including their sex life. MS can create physical and emotional barriers that must be overcome to have a healthy sex life. Here is what you need to know about sex and MS.

Key takeaways:
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    MS can decrease sex drive and cause sexual dysfunction in men and women.
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    The emotional toll of MS can affect sexual function and intimate relationships.
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    Sexual dysfunction caused by MS is treatable with medication and other therapies. Patience, communication, and therapy can help improve relationship problems caused by MS.

Multiple Sclerosis (MS)

Multiple sclerosis affects 2.8 million people worldwide, including 1 million people in the United States alone. MS is an immune-mediated disease that occurs when the body’s immune system attacks healthy nerve cells, ultimately preventing nerves from communicating with one another. MS affects nerves within the brain and throughout the body, causing both physical and mental problems. MS affects the body and the mind, both of which are involved in sexual function.

MS can affect different parts of the brain as well as different parts of the body. This causes people with MS to have different symptoms, severity, and disease progression. While individual experiences with MS vary, MS presents similar challenges and difficulties for everyone.

Physical effects of MS

MS can cause a variety of sexual problems, both directly and indirectly. These are described as primary, secondary, and tertiary sexual dysfunction. Because the brain plays a role in many different bodily functions, problems with communication within and outside the brain can affect sexual function by influencing hormone levels, mental sexual arousal, and physical sexual response. There are many, often unexpected, ways that MS can impact your life.

The effects of primary sexual dysfunction caused by MS include:

  • Low libido (sex drive).
  • Numbness or decreased sensitivity of the genitals.
  • Erectile dysfunction.
  • Poor vaginal lubrication.
  • Difficulty achieving orgasm or ejaculation.

Secondary sexual dysfunction caused by MS includes:

  • Muscle weakness.
  • Muscle spasticity.
  • Fatigue.
  • Pain.
  • Incontinence.

Emotional effects of MS

Sex is both physical and mental; your mental or emotional state affects your sex life. MS can have a profoundly negative impact on mental health and relationships.

Tertiary sexual dysfunction includes problems caused by the emotional and psychological effects of MS.

Depression can cause sexual dysfunction by lowering sex drive, decreasing sexual arousal, and preventing or delaying orgasm. Low self-esteem and poor body image can lead to emotional insecurity. Physical and emotional problems caused by MS can make it difficult to establish and maintain intimate relationships.

How to improve sex with MS

MS, like other chronic illnesses, can force you to make adjustments to how you would normally do things in your day-to-day life; this includes sex. You can improve your sex life by understanding the effects that MS has on your body and mind and making changes to your physical and emotional approach to sex.

Treat sexual dysfunction

MS causes sexual dysfunction in men and women, but it is treatable. There are many treatments available for erectile dysfunction, but there are also treatments available for women with sexual dysfunction marked by difficulty with arousal and orgasm.

To improve sexual dysfunction caused by MS:

  • Treat erectile dysfunction (pills, injections, pumps).
  • Treat female arousal problems with Addyi (flibanserin) or Vyleesi (bremelanotide).
  • Use water-soluble lubrication liberally.
  • Use sex toys to increase stimulation.

Make adjustments based on your limitations

Weakness, pain, and physical limitations can make sex more difficult, but you can make adjustments to your sexual routine to account for these things.

To overcome physical limitations caused by MS:

  • Adjust sexual positions to increase comfort, reduce pain, and improve stimulation;
  • Use medication to help with incontinence;
  • Take medication side effects into account; adjust when you take medications.

Building better relationships with MS

Physical difficulties caused by MS are only half of the problem; the other half is mental. Building and maintaining healthy intimate relationships can be difficult regardless of physical limitations or emotional problems. Relationship problems affect everyone at some point in their lives, whether you have MS or not. Any relationship, sexual or not, can benefit from self-care, patience, and good communication.

To have a healthy intimate relationship with MS:

  • Seek support, therapy, and/or medication to deal with emotional problems;
  • Communicate your needs, desires, and expectations with your partner;
  • Consider couples counseling or sexual therapy.

Communication is the cornerstone of any interpersonal relationship. Good communication is essential for healthy intimate relationships, especially when there are barriers that make intimacy more difficult. Perhaps the most important steps you can take to strengthen a relationship is to share your expectations with your partner and work together to meet those expectations.

Multiple sclerosis takes a physical and emotional toll on those who suffer from it. MS can decrease sexual drive, impair sexual function, make sex physically difficult, and damage intimate relationships. Fortunately, there are ways to improve sexual drive and function in those with MS by using medication and other sexual dysfunction therapies. Additionally, understanding the limitations to sexual activity caused by MS can help you make adjustments that allow you to meet your physical needs. Finally, patience and good communication with your partner are essential for establishing and maintaining a healthy intimate relationship.

A diagnosis of MS is life-changing for both you and those closest to you. MS presents many challenges to living a “normal” life, but those challenges can be met and conquered. Don’t let a diagnosis of MS or other chronic illness keep you from pursuing intimacy or other things that help make life fulfilling.


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