Sex and Multiple Sclerosis

Q: I have multiple sclerosis, and it is starting to really affect my sex life with my husband. How common is this? Is it all related to MS? What can be done?

A: It has been estimated that more than 50 percent of women and 75 percent of men of men with MS experience some form of sexual dysfunction during the course of their condition. So, you are definitely not alone. Sexual areas affected include temporary or long-term loss of interest in sex, inability to achieve orgasm, difficulty engaging in intercourse because of physical changes, or complete lack of erection.

For women, changes in sexual function typically occur early in the condition but tend to be milder than for men, especially at first. Lowered sexual desire, as well as decreased or absent lubrication, are almost as common as diminished orgasmic capacity, changes in orgasmic quality and inability to reach orgasm.

It is hard for me to say whether MS is the only cause -- or the direct cause -- of all your difficulties. Fatigue, for example, may discourage people from engaging in sexual activity, and depression, cognitive changes and relationship side effects also play a major role. In addition, the drugs used to treat MS (e.g., antidepressants, antispasmodics and anti-anxiety agents) may have a negative influence.

Several coping methods have been suggested, including the following:

• Plan sex early in the morning to avoid fatigue problems.
• Use side or rear entry to avoid hip abductors spasms in women with MS.
• Use vibrators when sensitivity is affected.

You should also consider talking to your doctor about the specific problems you are having. While it can be uncomfortable to talk about these issues, it can be reassuring to hear from a professional that your symptoms are not uncommon, not your fault, and furthermore, he or she could have some helpful suggestions.