Sexual difficulties - particularly erectile dysfunction and difficulty reaching orgasm - are common in men with MS. Sexual problems often result from a complex interaction of physical, social, psychological and emotional elements.
You may find it awkward or embarrassing to talk about sex, but there is support available. Although there are drugs for some symptoms, the key element in managing sexual issues is the willingness to discuss problems.
What causes sexual problems for men with multiple sclerosis?
For many people, sexual problems are caused by a combination of physical, psychological, emotional and social factors. These fall into three broad groups:
- Caused directly by MS damage to nerve pathways in the brain and spinal cord that control sexual feelings and responses
- Caused indirectly by symptoms of MS, such as bladder symptoms, fatigue, low mood and depression or spasticity, or from prescribed medications
- Resulting from the wider consequences of living with MS. This can undermine your sense of self, sexual identity and enjoyment, and your confidence as a sexual partner or potential partner. Emotional reactions can be an issue for both the man with MS and his partner, and relationship difficulties are commonly reported
Having MS doesn't stop you from experiencing sexual difficulties unrelated to the condition. Problems with erections and orgasms are relatively common in the general population and can be due to a number of causes unrelated to MS such as alcohol or drug use, other health conditions or age
How many men with MS have sexual problems?
Difficulty with erections, orgasms and having satisfying sex are not unusual. Studies estimate that more than half of men with MS will be affected by sexual problems to some degree at some time - some studies suggest up to 90%. Some difficulties may be long lasting or permanent whilst others may come and go. Although sexual concerns are more likely the longer someone has had MS, they can occur at any time.
What can I do if I have sexual problems?
The most important starting point for managing sexual issues is being willing to talk about them. You may find it awkward or embarrassing to talk about sex, but there is support available.
Finding effective treatment for your sexual issues needs careful analysis of all the elements that are affecting you. For example, if fatigue is affecting your sexual performance, a pill that makes it easier to achieve an erection is not going to resolve the problem of physical stamina. Similarly, medication alone won't resolve feelings of being unattractive or sexually less desirable.
Rather than focussing on intercourse and the pursuit of erection and orgasm, it might be more fulfilling and rewarding to explore more mutually caring and supportive approaches, such as focussing on touch and sensuality.
Last updated: 29 September 2015
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