MS, sex and relationships

Almost everyone experiences problems with sex or relationships at some point in their life, but this can be even more challenging with MS and MS related symptoms in the mix.  

Article medically reviewed by Karen Vernon an MS Nursing Specialist at Salford Royal Foundation Trust, UK.

It’s not the easiest of conversations to have, but can we talk about… y’know… sex? Specifically, sex when you have MS? Let’s be honest here – sex and relationships can be tricky to navigate at the best of times, and for some people, MS adds another series of unwanted challenges to deal with, on top of everything else.

We briefly covered sexual problems in our guide to multiple symptoms here. Yes, it can certainly be embarrassing to discuss, and that goes for anyone, living with or without MS – vaginal dryness or erectile dysfunction aren’t exactly popular small talk topics of conversation. 

But, it’s worth knowing that sexual problems are among the more common MS symptoms, so rest assured you’re not alone. A lot of people living with multiple sclerosis – and a lot of people who don’t have multiple sclerosis – experience sexual issues at some time or another. And, with a lot of health-related issues, the starting point for dealing with them is by talking about them.

“This is a super important topic for everyone, because we are all human.”
“Well… happy to see that I’m not the only one who has problems in this department.” @RoxanaM

Shaun talks about how MS has affected his sex life in an episode from our Animated Symptoms series. Watch the video below and read the conversation here.

Join the community today – it’s completely free – to start sharing and finding help.

Why does multiple sclerosis cause sexual problems?

Multiple sclerosis causes sexual problems in a number of ways – some direct, some as a result of other symptoms. Firstly, MS causes nerve damage, and impacts messages from the brain to other parts of the body. This means the messages that the brain sends to the sexual organs, which trigger sexual function, are compromised, which then leads to issues.

Common symptoms of MS can inevitably cause sexual problems. We’re talking fatigue – if you’re feeling exhausted, it stands to reason that sex is going to be completely off the menu – and mental health issues, such as depression. Mental health issues are commonplace for many people with multiple sclerosis and, again, it can be difficult to be ‘in the mood’ if that mood is low. 

Another common symptom, spasticity, can create problems too. Spasticity makes muscles stiffen to various degrees, which can make some forms of sexual activity uncomfortable or even painful.

In a general sense, some MSers may also feel that their self-esteem and overall confidence declines, which can then have a knock-on effect on their sex lives. If you’re not feeling good about yourself, it can be easier to avoid intimacy.

Some types of MS treatment can also cause sexual problems. If you’ve noticed a change in your sex life since starting on disease modifying therapies (DMTs), it’s probably worth discussing this with your MS support team. They may suggest changing to another course of treatment instead. Side effects from medication used for symptom control (such as antidepressants or medication for neuropathic pain) can also cause sexual problems. 

“My fatigue usually means I’m too knackered to think about doing anything in bed but sleep.” @Becks

What sexual problems can MS cause?

MS can impact your sex life in a number of ways, though everyone will be affected differently – and some not at all. Both men and women with MS can experience sexual problems. Clearly, men and women can experience different issues, but there are other problems that might be common regardless of gender.

Lack of interest in sex, and a loss of libido or sex drive are typical problems – though some people with multiple sclerosis might find their libido accelerates; further proof that MS really isn’t the same for everyone. Bladder and bowel issues can also have an impact on your sex life.

“With MS I must say mine has gone the other way my sex drive is higher.” @Ljones

Both men and women could have difficulty reaching orgasm. For men, erectile dysfunction and issues with ejaculation are familiar problems – they can affect many men who are otherwise healthy too, of course. A lack of sensation and feeling may also contribute to a failure to climax, with some MSers reporting ‘numbness’. How can you feel good if you can’t feel anything? For women with MS, sex can be uncomfortable due to vaginal dryness.

“Do any other ladies have any trouble ‘getting there’ during sex?” @Lindsay82

Managing sexual problems when you have MS

It’s not easy dealing with sexual problems when you have multiple sclerosis. Talking about it can be embarrassing, but it’s the first step towards managing sexual problems and improving the situation.

That communication needs to open up with a partner, if you’re in a relationship. It can be a difficult series of conversations to have, whether you’ve been in a long-term relationship and the dynamic between the two of you has changed significantly, or a relatively new one that is still in its early stages. Your partner may be concerned about your health, and how to ‘be’ with you now.

“My husband was apprehensive just after I was diagnosed, because he didn’t want to hurt me, or upset me, or anything. He was happy to wait till I was ready.” @Tiggermum

Sexual problems can put a strain on relationships. There can be a lot of hurt on both sides, especially if you can’t have the same kind of sex life that you were previously used to. There may be sexual acts that you can’t perform any longer, or at least in the short term. You may need to reset your sex life, focusing more on intimacy, and touching, and talking, than the end goal of orgasm – but the starting point is often talking about your feelings, and fears, and going from there.

Some types of MS treatment can help to improve sexual problems. Drugs such as viagra and cialis can be prescribed to treat erectile problems in men, and lubricants might be one possible solution for women who are experiencing vaginal dryness. If specific MS symptoms are making sex difficult – such as spasticity – it may be worth talking to your doctor or multiple sclerosis specialist about starting on an MS treatment that reduces the severity of those symptoms.

While conversations about sex and intimacy can be difficult to have, don’t be embarrassed about talking to your MS team about any concerns. If your MS nurse or doctor ask you specifically about sexual problems, try to be as honest as possible. Your team will help and support you in any problems you’re experiencing.

Members of our community discuss how their relationships have been impacted by multiple sclerosis. Watch our short video below.

Join the community today – it’s completely free – to start sharing and finding help.

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