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    Romance and Multiple Sclerosis

    Adults with multiple sclerosis find that self-acceptance and open communication can unlock the door to dating and intimacy.

    Causes of Sexual Dysfunction

    "There's no relationship between disability and sexual function," says Marie Namey, RN, MSN, a clinical nurse specialist at The Cleveland Clinic's Mellen Center for Multiple Sclerosis Treatment and Research. "It can affect individuals with no visible symptoms."

    While it's sometimes difficult to tease out the exact origin of sexual dysfunction, professionals have categorized MS-related sexual dysfunction into three types.

    Primary sexual dysfunction can result from the formation of MS lesions on the spinal cord affecting nerve pathways. "There are so many pathways along the spinal cord that mediate different aspects of sexual function -- drive, orgasm, arousal. Because there are so many, there's a good probability that there's going to be a lesion somewhere along the way," says Frederick W. Foley, PhD, a neuropsychologist and expert on sexual dysfunction in people with MS.

    Then there's secondary sexual dysfunction. That's when MS symptoms or medical interventions interfere with sexual function or expression. For instance, many people with MS suffer from bladder dysfunction, an inability to control urination. "Concern about having bladder problems during sex is common," says Namey. Fatigue, another common symptom of MS, also zaps people's interest in sex.

    Tertiary sexual dysfunction -- a cluster of psychological, social, and cultural issues -- can also play a role. "Some people have an altered body image. They may lack self-esteem due to a change of status in life, whether it's a professional change or something else," Namey tells WebMD.

    Help for Sexual Dysfunction

    Despite the high incidence of sexual dysfunction among adults with MS, experts say it's often reversible. They advocate honest, open communication to jump-start the process.

    "Most people have inhibitions when it comes to talking about sex. In our country, sex is either framed as pornographic or highly medicalized. There's not a good in-between language for people to comfortably talk about sexuality," Foley tells WebMD.

    "If you can get people to talk about sexuality, they can sometimes solve their own problems," he adds.

    Others find help through formal counseling interventions.

    "The vast majority of people with MS and their partners can find help in a relatively short period of time," Foley says, recalling a young female patient of his. Prior to being diagnosed with MS, she enjoyed a healthy sex life with her partner. Shortly after being diagnosed with MS, she lost all interest in sex. "Her sudden loss of libido was very distressing for her," Foley says. Even more distressing, her medical team found no specific psychological or medical cause to her sexual dysfunction. But they didn't give up on treating her.

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