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A to Z of MS Sexual issues

Despite a significant number of people with MS experiencing sexual difficulties and the negative effect these can have on quality of life, it is often a symptom that receives little attention. Many people will not discuss the sexual difficulties they are experiencing, generally due to embarrassment and shyness. Some people may believe that sexual problems are an inevitable consequence of MS and are yet another symptom that has to be endured. Others may assume that any sexual problems are unrelated to their MS.

Sexual difficulties can be experienced at any time during the course of MS. Sometimes problems are minor and can be managed easily with general advice, at other times they can be more significant and require specialist input.

Types of sexual problems

Commonly reported sexual difficulties tend to be associated with loss of interest in or the ability to perform sexual intercourse. It is also well known that the living and coping with this complicated disease has a huge impact on intimacy and relationships.

Sexual difficulties reported by men include:

  • decreased or absent sexual desire
  • erectile duysfunction - problems achieving or maintaining an erection
  • altered sensation in the penis
  • decreased frequency/intensity of orgasms
  • premature ejaculation

Sexual difficulties reported by women include:

  • decreased or absent sexual desire
  • altered genital sensation
  • decreased frequency/intensity of orgasms
  • decreased vaginal lubrication and clitoral engorgement
  • decreased vaginal muscle tone
  • pain on penetration

Some people can experience sexual difficulties as a result of other MS symptoms such as bladder problems, fatigue or spasticity, or from prescribed medications.

Living with MS, especially when it is disabling, can produce an immeasurable effect on someone's self-esteem and self-image. Emotional reactions can be a fundamental issue for both the person with MS and their partner, and relationship difficulties are commonly reported.

With the exception of certain types of erectile dysfunction, the sexual problems experienced by people with MS do not affect fertility.

Treatment

Not every sexual problem is due to MS and many of the difficulties described by people with MS also occur in the general population, eg: anxiety, sleepless nights and so on.

Treatment of MS related sexual issues can involve counselling and finding new ways of being intimate that are better suited to the individual's situation. For men with erectile dysfunction, there are now drugs such as sidenafil citrate (Viagra), vardenafil (Levitra) and tadalfinil (Cialis).

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