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.
  • Pain

Tertiary sexual effects

These symptoms result from psychological or social issues that interfere with sexual feelings and/or response:

  • Depression
  • Performance anxiety
  • Changes in self-image or body image