Multiple Sclerosis: Maintaining Intimacy

It is not surprising that many people with multiple sclerosis report a decline in sexual desire. What with the fatigue, muscle spasms, and bladder control problems, who would want to think about sex? But, there are steps that can be taken to improve sexual function and intimacy, despite MS.

How Does MS Impact Sexual Function?

Changes in sexual function can occur as a result of the neurologic and psychological affects of MS.

Neurologic

Sexual arousal begins in the central nervous system, as the brain sends messages to the sexual organs along the nerve pathway in the spinal cord. MS-related changes to these nerve pathways can directly or indirectly impair sexual functioning. For example, the following symptoms can occur as a direct result of myelin breakdown in the spinal cord or brain:

• Decreased sex drive
• Altered genital sensations (numbness, pain, increased sensitivity)
• Difficulty or inability to maintain erection
• Decreased vaginal lubrication
• Decreased vaginal muscle tone
• Ejaculation difficulty
• Problems having an orgasm

The following symptoms can arise as a consequence of MS physical changes or treatments:

• Fatigue can suppress sexual desire
• Spasticity can interfere with sexual positioning or cause pain
• Sensory changes can make physical contact uncomfortable.
• Pain

Psychological

A loss of interest in sexual contact or intimacy may arise as a result of psychological or social issues, such as:

• Depression
• Performance anxiety
• Changes in self-image or body image as a result of disability

What Can Be Done to Improve Intimacy and Sexual Relations?

• Talk to your partner. The most important way of dealing with sexual difficulties is to discuss your feelings with your loved one. When MS begins affecting your sexual desire, talk to your partner. Confiding in your partner deepens intimacy and may help resolve concerns relating to sexual intimacy.

Reviewed by the doctors at the Mellen Center for Multiple Sclerosis Research at The Cleveland Clinic.