MS and Your Sex Life
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MUSIC PLAYING:
I think of sexual function as being impacted by two different systems. So your sexual function could be affected by affecting your electrical system. So MS is a neurological problem. So it's affecting the brain and spinal cord, which is part of your electrical system, if you will.
So your sex life could also be affected by your plumbing system. So if MS affects, say, your bladder function, that could have indirect impacts upon your sex life as well. So those are probably the two major ways that multiple sclerosis can affect someone's sex life directly, is either through affecting the electrical system or through the plumbing system. We could talk a lot about secondary effects, so things like weakness and spasticity and fatigue and mood changes, and how those things can indirectly affect a person's sex life.
[MUSIC PLAYING] Issues in men and women are going to be a little bit different. So if we start with guys, so with men and sexual dysfunction, we're sometimes dealing with erectile dysfunction or difficulty with orgasm. So with erectile dysfunction, again, it's very much the plumbing system or the electrical system. And we want to really dive in with erectile dysfunction and think about, is this a direct result of the MS or are the secondary effects like those mood changes?
The delayed orgasm that we see in men with MS sometimes is the result of medication side effects. So there are so many different layers to sexual issues in MS.
[MUSIC PLAYING] When we think about female sexual dysfunction, we also see delayed orgasm or inability to orgasm is an issue. We see sometimes difficulty with pain with sexual intercourse with women with MS. Bladder issues in both men and women can be an issue. So if you have a small overactive bladder, and you have to empty your bladder every 15 minutes, that's going to be a little bit disruptive to your sex life. And so we have ways that we can manage those bladder issues.
There is an opposite bladder problem in multiple sclerosis where you have a large underactive bladder. And in that situation, there's always some urine in the bladder. And in those cases, we may sometimes need to think about mechanically emptying the bladder with catheterization before the person has sex.
[MUSIC PLAYING] So multiple sclerosis is incredibly varied from person-to-person. So there are no two identical cases of multiple sclerosis. So we have individuals who are very mildly affected, and individuals who have more significant challenges. So we have to acknowledge up front that there's not going to be kind of a one size fits all treatment pattern for sexual issues and multiple sclerosis.
[MUSIC PLAYING] When we think about someone's sex life, we probably should put it into the broader terms of intimacy and not just sex. One of the greatest lessons I learned from an individual with MS, who's a gentleman with MS, who has had a lot of physical challenges with his MS. And he said, in some ways, he had lost some things. He had lost some of the ability to actually have intercourse, but he had gained a lot in intimacy.
So he and his wife were actually closer from an intimate standpoint. There was more hugging, cuddling, talking, kissing than there was actual intercourse. And so I think we want to make sure when we're having that sex talk with individuals that we're not just focusing on the act of intercourse itself.
[MUSIC PLAYING] I think one of the keys to managing sexual issues and in a man or a woman with MS is to get them to be really honest about it. They have to be willing to put the cards on the table and tell us exactly what's going on and not be embarrassed about it. And we as health care providers have to not be embarrassed about it. We have to be willing to have open and honest discussions when people open up about these problems, and look at it, all the different layers of how we can address these issues in such a complex problem with so many different potential challenges.
But each one of those challenges does represent an opportunity for us to intervene. I think the couples themselves have to be honest with each other and let the other person know what's going on. What I see in a lot of couples is there are assumptions that are made that my partner must think X when, in fact, maybe the partner doesn't think X. Maybe they really think Y. And so there are sometimes self-destructive pathways that people take because they assume they know what the other person's thinking. And so that open dialogue I think is very important for us to work through this for individuals.
Part of quality of life for many people is having a normal sex life. It's very important that everyone realize that what's normal in a person's sex life is very individual. There's no right amount of sex.
There's no right kind of sex. It's whatever works for that couple. And I think the job of the health care team is to try to help that person get to that point where they're satisfied and they're happy.
BEN THROWER
When we think about Multiple Sclerosis and a person's sex life, I always like to back up and say, our goal in MS management is to try to make MS as small a part as possible in a person's life. And for quality of life, sex is important for a lot of people. So we want to make sure that if sex is important, that people are able to maintain that. I think of sexual function as being impacted by two different systems. So your sexual function could be affected by affecting your electrical system. So MS is a neurological problem. So it's affecting the brain and spinal cord, which is part of your electrical system, if you will.
So your sex life could also be affected by your plumbing system. So if MS affects, say, your bladder function, that could have indirect impacts upon your sex life as well. So those are probably the two major ways that multiple sclerosis can affect someone's sex life directly, is either through affecting the electrical system or through the plumbing system. We could talk a lot about secondary effects, so things like weakness and spasticity and fatigue and mood changes, and how those things can indirectly affect a person's sex life.
[MUSIC PLAYING] Issues in men and women are going to be a little bit different. So if we start with guys, so with men and sexual dysfunction, we're sometimes dealing with erectile dysfunction or difficulty with orgasm. So with erectile dysfunction, again, it's very much the plumbing system or the electrical system. And we want to really dive in with erectile dysfunction and think about, is this a direct result of the MS or are the secondary effects like those mood changes?
The delayed orgasm that we see in men with MS sometimes is the result of medication side effects. So there are so many different layers to sexual issues in MS.
[MUSIC PLAYING] When we think about female sexual dysfunction, we also see delayed orgasm or inability to orgasm is an issue. We see sometimes difficulty with pain with sexual intercourse with women with MS. Bladder issues in both men and women can be an issue. So if you have a small overactive bladder, and you have to empty your bladder every 15 minutes, that's going to be a little bit disruptive to your sex life. And so we have ways that we can manage those bladder issues.
There is an opposite bladder problem in multiple sclerosis where you have a large underactive bladder. And in that situation, there's always some urine in the bladder. And in those cases, we may sometimes need to think about mechanically emptying the bladder with catheterization before the person has sex.
[MUSIC PLAYING] So multiple sclerosis is incredibly varied from person-to-person. So there are no two identical cases of multiple sclerosis. So we have individuals who are very mildly affected, and individuals who have more significant challenges. So we have to acknowledge up front that there's not going to be kind of a one size fits all treatment pattern for sexual issues and multiple sclerosis.
[MUSIC PLAYING] When we think about someone's sex life, we probably should put it into the broader terms of intimacy and not just sex. One of the greatest lessons I learned from an individual with MS, who's a gentleman with MS, who has had a lot of physical challenges with his MS. And he said, in some ways, he had lost some things. He had lost some of the ability to actually have intercourse, but he had gained a lot in intimacy.
So he and his wife were actually closer from an intimate standpoint. There was more hugging, cuddling, talking, kissing than there was actual intercourse. And so I think we want to make sure when we're having that sex talk with individuals that we're not just focusing on the act of intercourse itself.
[MUSIC PLAYING] I think one of the keys to managing sexual issues and in a man or a woman with MS is to get them to be really honest about it. They have to be willing to put the cards on the table and tell us exactly what's going on and not be embarrassed about it. And we as health care providers have to not be embarrassed about it. We have to be willing to have open and honest discussions when people open up about these problems, and look at it, all the different layers of how we can address these issues in such a complex problem with so many different potential challenges.
But each one of those challenges does represent an opportunity for us to intervene. I think the couples themselves have to be honest with each other and let the other person know what's going on. What I see in a lot of couples is there are assumptions that are made that my partner must think X when, in fact, maybe the partner doesn't think X. Maybe they really think Y. And so there are sometimes self-destructive pathways that people take because they assume they know what the other person's thinking. And so that open dialogue I think is very important for us to work through this for individuals.
Part of quality of life for many people is having a normal sex life. It's very important that everyone realize that what's normal in a person's sex life is very individual. There's no right amount of sex.
There's no right kind of sex. It's whatever works for that couple. And I think the job of the health care team is to try to help that person get to that point where they're satisfied and they're happy.
