Sexual health is an important part of overall well-being, yet it is one of the least discussed symptoms of multiple sclerosis (MS).
Studies suggest that 50โ80% of women and 40โ70% of men with MS experience sexual dysfunction. These issues can occur early or later in the disease and affect people regardless of age or relationship status. Sexual difficulties can have a significant impact on self-esteem, intimate relationships, and quality of life.
Sexual function depends on healthy communication between the brain, spinal cord, nerves, blood vessels, hormones, and emotions. Because MS damages nerve pathways within the central nervous system, it can interfere with these signals.
Primary sexual dysfunction results directly from MS-related nerve damage and may include reduced desire, decreased genital sensation, difficulty with arousal or orgasm, erectile dysfunction, or reduced vaginal lubrication.
Secondary sexual dysfunction develops because of fatigue, weakness, spasticity, pain, bladder or bowel symptoms, or mobility limitations.
Tertiary sexual dysfunction reflects the emotional effects of MS, including depression, anxiety, body image concerns, relationship stress, and reduced confidence.
Women may experience vaginal dryness, reduced sensation, pain during intercourse, delayed orgasm, or lower libido. Men commonly report erectile dysfunction, reduced sensation, delayed ejaculation, difficulty reaching orgasm, or reduced sexual desire.
Fatigue is one of the most common barriers. Keeping the room cool may help.
Meds used to treat MS associated symptoms may also be a factor, including those to treat depression, anxiety, bladder symptoms, pain, or spasticity.
Men often benefit from meds for erectile dysfunction. Women may benefit from lubricants, or hormone therapy. Pelvic floor physical therapy, counseling, and emptying the bladder before intercourse can also improve comfort and satisfaction.
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