Living with MS can have a profound impact on sex drive and sexual desire. It can undermine your sense of self, sexual identity and enjoyment, and your confidence as a sexual partner or potential partner. For some this may cause occasional, temporary episodes when it is difficult to be motivated or interested in sex. For others it can result in a lasting reduction in sex drive.
There are lifestyle approaches that may help you challenge some of the effects of reduced sexual desire.
What is sexual desire?
Sexual desire or sex drive (libido) is the urge to engage in sexual activity. Although not properly understood, desire is thought to be a combination of psychological elements - including how you think of yourself, how you think about a partner, previous positive and negative experiences of sex, cultural and religious factors, your mood - together with physiological factors such as hormones and nerve activity in the brain.
What causes reduced sexual desire?
A range of factors can have a role in reducing the desire for sex
- A loss of self-confidence may make you feel bad about yourself or make you feel self-conscious about how you look to others. This may make you feel isolated, less attractive and thus less interested in sex. You may worry that you are no longer fulfilling your sexual role in a relationship - even if your partner is not expressing any discontent. Lacking the desire for sex may make sexual activity less fulfilling when it does take place.
- MS symptoms may undermine your sex drive. For instance, fatigue and depression can undermine desire, or pain and spasms can make sex physically uncomfortable. Fear of symptoms can also play a role. For example being anxious about wetting or soiling yourself might inhibit anticipation and pleasure.
- Issues unrelated to MS also play a part. Stress, anxiety and depression can all have an effect, as can worrying about things like work or finances. Physical factors such as hormone imbalance can also lower sex drive, as can alcohol or drug use.
How many people have reduced sexual desire?
Research studies found that between three and four people in ten in the general population have a decreased interest in sex. However, as sexual problems are probably under reported by people with MS, it is difficult to how many people with the condition are affected.
What can I do if I have reduced sexual desire?
Difficulty in satisfying your sexual needs can be a cause of frustration, disappointment and distress. The most important and most powerful starting point for managing sexual issues is a willingness to talk about them. Read more about talking about sexual issues
Negative thoughts about yourself as a sexual partner can result in a vicious circle - if you feel bad about yourself you will be less inclined to take part in sexual activity, which makes you feel worse. Making changes and choices to challenge these feelings takes time and effort but the cycle can be stopped.
Approaches such as CBT (cognitive behavioural therapy), acceptance and commitment therapy (ACT) and mindfulness can help you recognise negative thoughts, feelings and behaviours and help to find new, positive ways of managing. With practise you can learn to recognise and manage these thoughts and have a successful sex life despite them.
If MS is reducing your confidence, you may feel like shutting yourself off from the world - particularly if relationships suffer setbacks. Keeping in regular contact with friends and meeting other people helps to keep difficulties in proportion. If you are looking for a partner, dating websites offer a way to build up confidence before arranging a face to face meeting.
Staying as active as circumstances allow is vital to good health. It can help reduce stress, low mood and fatigue. This need not mean following an exercise regime or taking up a sport. Activities such as gardening or photography get you out and about can help you to feel better about yourself.
Look after yourself
Taking care of your appearance can help you maintain a positive outlook. Sometimes it can be a struggle to get up, dressed and groomed for the day ahead but making that effort to look good can help you challenge negative feelings of lack of confidence or self-worth.
Remember your strengths
Although MS may have affected some of the things you can do, think of things that you like about yourself and what you see as your strengths. There may be new strengths that have arisen from living with MS, such as resilience, adaptability or sense of humour.
Sexually this is important too. It is not always what you do, but how you do it. If certain activities or positions are difficult or no longer pleasurable, find out what does work and concentrate on that. And consider your partner's needs - what do they like and how can you achieve this?
It's not all about orgasm
Expressing love, affection, intimacy and sensuality do not depend on penetrative sex and a relentless quest for orgasm. Try to enjoy the process, exploring sensuality and touch, without being distracted by the need to reach climax.
Taking the focus away from sex itself is an approach sometimes used by sex therapists. Simple closeness, such as holding hands or cuddling and enjoying each other's company are vital to a relationship and can reassure both partners that they are the object of affection. This distance can help the couple to reassess what is important to their relationship and also consider their erotic and sexual likes and dislikes without the pressure to try to instantly act them out.
Talking about sexual problems
The most important and most powerful starting point for managing sexual problems due to multiple sclerosis is to be willing to talk about them.
Sex and MS: depression, fatigue and disability
1 September 2017
This research looks at the relationship between sexual problems in MS and symptoms, such as depression, fatigue and level of disability.
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Last updated: December 2017
Last reviewed: September 2015
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