How can multiple sclerosis (MS) affect sex and intimacy?
Intimacy with a loved one is an important component of a healthy, contended life. It does not have to disappear from the lives of couples when one partner has MS.
MS can affect the experience of intimacy in a variety of ways. Some people report changes in sexual function or feel disinterested in sexual contact. Some women report a lack of sensation or loss of sexual desire, some men report erectile dysfunction as being the most common problem with sexual function. These changes in sexual function can be either a direct result of the neurologic changes, symptomatic (spasticity or bladder problems) or can be a result of psychosocial problems (not feeling sexually attractive due to a disability).
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.
What are the sexual effects of multiple sclerosis (MS)?
Primary sexual effects
These 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
- Difficulty to ejaculate
- Problems having an orgasm
Secondary sexual effects
These 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
- Bladder or bowel problems are closely related with sexual dysfunction because the nerve pathways are nearby or shared.
- Sensory changes can make physical contact uncomfortable.
Tertiary sexual effects
These symptoms result from psychological or social issues that interfere with sexual feelings and/or response:
- Performance anxiety
- Changes in self-image or body image