Multiple sclerosis (MS) is a condition that impacts the body’s central nervous system, which is made up of the brain and the spinal cord. For reasons currently unknown, when a person has MS, their immune system attacks the protective covering around their nerves (known as the myelin) and causes communication issues between the brain and the rest of the body. Depending on the severity of the condition, MS can cause a number of symptoms including vision problems, fatigue, dizziness, numbness, tingling, weakness in limbs, problems with bowel and bladder functions, and/or paralysis. These symptoms may be temporary or permanent.

How might MS affect a person’s sexual function?

Sexual problems are common among individuals with and without MS, but MS may introduce additional elements to consider when it comes to a person’s sex life. MS can impact a person’s sexual functioning in direct and indirect ways.

Direct effects of MS on sexual function:

The direct effects of MS on a person’s sexual function are caused by damage to the myelin that impairs the brain’s ability to communicate with other parts of the body, including the sexual organs. When the body’s nerve fibers are unable to relay messages from the brain to the genitals as effectively, it can cause:

• Changes in genital sensations such as genital numbness, pain, or hypersensitivity.
• Decreased or absent sex drive.
• Decreased sexual arousal.
• Difficulties reaching orgasm.
• Less intense orgasms.
• Reduced vaginal lubrication in women.
• Erectile dysfunction (ED) in men.
• Ejaculatory difficulties in men.

Indirect effects of MS on sexual function:

Just as important to consider are the indirect effects that MS may have on a person’s sexual function. Similar to other chronic conditions, MS can result in physical and emotional strain that may interfere with a person’s ability to routinely engage in enjoyable, satisfying sexual activity. Some indirect effects of MS on sexual function may include:

• Constant fatigue that hinders an individual’s desire or motivation to engage in sexual activity.
• Low self-esteem or poor self-image due to changes caused by MS that can impact a person’s confidence when it comes to sex.
• Concerns about experiencing bladder or bowel problems during sex.
• Feelings of grief, depression, anxiety, stress, and demoralization that can disrupt sexual pleasure.
• Abnormal muscle tightness that causes painful, involuntary spasms of the limbs (spasticity) is an MS symptom that can make sex physically uncomfortable or painful.
• Tremors in the hands or other parts of the body may impact touch and the sensory elements of a sexual experience.
• MS medications may have side effects that dampen sexual desire and arousal.

How can a person with MS thrive sexually?

Changes in a person’s sexuality are often accompanied by feelings of loss, sadness, anger, and depression. While this is completely normal, it is important to know individuals with MS can still have meaningful sexual relationships and enjoyable sexual experiences. The following are suggestions of ways that people with MS can support their sexuality despite changes in their sexual function.

Communication with a sexual partner (or partners) is key for people with MS who wish to maintain a satisfying sex life. While it may seem embarrassing to express concerns about changes in sexual function, possible bladder or bowel issues, or feelings of insecurity or low self-esteem with a partner, being open has its advantages. Sharing such information with a sexual partner can reduce anxiety around sex as well as the emotional burden of having to deal with the changes alone. It can also open the door for discussions about what feels good or bad during sex, which may have changed since the onset of the MS.

Speaking with medical professionals about your sexual health may also be beneficial for people with MS. Health care providers can help individuals manage their medications to better control their symptoms and provide suggestions for optimal sexual health outcomes. They may also be able to recommend treatment options for sexual dysfunction and/or refer patients to sex medicine specialists who can help.

Medications, devices, products, and sexual function aids are often simple additions to a sexual routine that can greatly improve the experience. Women who are struggling with reduced vaginal lubrication due to MS may consider using a personal lubricant during sexual activity. Oral ED medications, vacuum erection devices, intracavernosal injections, and penile implants are options for men who are experiencing erectile difficulties. Vibrators may be useful devices for both men and women who have experienced sensory changes in their genitals as a result of MS.

Individual or couples therapy is a good option for people who are coping with the emotional aspects of MS and the resulting changes in their physical or sexual function. Sex therapists are uniquely qualified to help couples overcome changes in sexuality and regain a fulfilling sex life.

Resources:

• Mayo Clinic. (2022, January 7). Multiple Sclerosis. https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269
  
  
• National Multiple Sclerosis Society. (2018). Intimacy and Sexuality in MS [Brochure]. https://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure-Intimacy-and-Sexuality.pdf
  
  
• National Multiple Sclerosis Society. (2022). What is MS? https://www.nationalmssociety.org/What-is-MS
  
  
• Vann, M.R. Medically reviewed by Jason Paul Chua, MD, PhD. (2021, July 30). How to Have a Healthy Sex Life When You Have Multiple Sclerosis. https://www.everydayhealth.com/multiple-sclerosis/living-with/maintaining-a-healthy-sex-life-when-you-have-ms/