Multiple sclerosis (MS) and sexual dysfunction: everything there is to know!

Multiple sclerosis and sexual problems: what is the link? 

In Multiple Sclerosis, sexual problems affect more than one in two patients (men and women) and can have a major impact on their well-being and quality of life. These dysfunctions can affect all phases of sexuality: desire, arousal, pleasure and orgasm. They can be regarded as symptoms and signs of MS and can appear early in the course of the disease.

In fact, there is no correlation between sexual problems and the duration of the disease, the level of disability, loss of mobility, or the number of relapses.

Sexual problems in MS can be linked to a number of things, including: the direct neurological damage caused by the disease, symptoms of the disease that are not based on the nerve pathways, and the psychological and social aspects of the disease.

These problems may manifest themselves differently in men and women.

Which sexual dysfunctions develop in men and women suffering from multiple sclerosis (MS)? 

In order to simplify the perception of MS-related sexuality disorders, the medical community distinguishes between three categories: primary disorders, secondary disorders and tertiary disorders.

Primary sexual dysfunctions 

The so-called primary sexuality disorders are closely linked to the neurological damage characteristic of multiple sclerosis. Demyelinating lesions of the central nervous system can alter the organization and complex control of sexual responses. MS can also alter the secretion of sex hormones.

In women, this causes reduced vaginal lubrication, reduced genital sensitivity, difficulty achieving orgasm and reduced libido (sexual desire).

In men, it manifests itself as erectile dysfunction (reduced ability to obtain and maintain a satisfactory erection), problems with ejaculation (premature or delayed), difficulty achieving orgasm, and reduced sexual desire (libido). 

Secondary sexual dysfunctions

Secondary sexual problems are essentially due to the consequences of the disability and the various symptoms of multiple sclerosis. Fatigue, pain, reduced mobility, muscular weakness, spasticity, urinary or anal leakage, and cognitive problems can all have a significant impact on libido and the ability to have satisfying sexual relations.

Moreover, certain treatments can have side effects that can have an impact on sexuality. This is particularly true of antidepressants, which can affect libido and make orgasms more difficult to achieve. 

Tertiary sexual dysfunctions 

Tertiary sexual problems are linked to the psychological aspects of multiple sclerosis and to the impact of the condition on the patient's relationships. Anxiety, stress, anger and mood disorders have a major impact on sex life.

In addition, the disability and symptoms of MS can lead to an altered self-image, which can result in lower self-esteem and loss of confidence in oneself in general and in one's ability to seduce others.

Multiple sclerosis, like any other disease, can also have an impact on a couple's relationship, making communication between the partners complicated. As a result, it becomes more difficult to maintain the closeness necessary for a fulfilling sexual relationship.

How to maintain a healthy and fulfilling sex life when you have multiple sclerosis (MS)? 

Sexual problems are not inevitable. There are many ways of dealing with some of them, and others can be treated medically and/or psychologically. It is possible to maintain or rediscover a fulfilling sexuality. To do this, you should: 

Talk to your healthcare team 

The first thing to do is talk to your neurologist or primary care physician. It can be difficult to talk about sex problems, yet doctors are aware of this aspect of MS and can be a great source of support. However, it is important that you have a good relationship with your physician and can trust them.

During the various appointments you have with your health care team, you should not feel that they have to focus solely on your MS symptoms; you can talk about the difficulties you encounter in your everyday life, including sexual problems. Doctors know that sexual problems are common among multiple sclerosis patients, and will be able to offer you solutions, for example, give practical advice (use of a lubricating cream, a sex toy, etc.), suggest medical treatment or, sometimes, refer you to other healthcare professionals such as a psychologist or a sexologist.  

Talk to your partner 

It is essential to communicate with your partner, as he or she is just as concerned as you are. Sharing your feelings and your respective difficulties is the best way to find solutions together and even to strengthen your relationship. On the contrary, things left unsaid can make the situation worse.

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