For those who are diagnosed with Multiple Sclerosis (MS), they often face the hard work of figuring out their new “normal” in everyday life with everyday tasks, and with intimacy and sexual function issues. While intimacy and intimate acts have been proven time and time again to benefit the body and boost health by reducing stress, easing tension and depression, encouraging the production and release of the “power” body chemicals and hormones like dopamine and serotonin, trigger better whole-body healing and overall wellness- many MS warriors face battles carrying out those acts and being intimate.
MS is a progressive, disabling, life-changing spinal cord and brain disease that affects the CNS, or central nervous system. The body’s immune system becomes confused and attacks the myelin sheath covering the nerve fibers, causing internal communication issues inside of your body. This disease can leave permanent damage to the nerves.
Signs of multiple sclerosis vary between people and depend on the location and severity of the nerve damage to the nervous system. Scans can help doctors to know where the brain and spinal cord lesions are around the body. Some will have extremely severe flares of MS, with hospital stays, unwavering symptoms, and struggle. Others may have little to no flares, issues, or symptoms. There are many treatments available for people, but currently no cure.

“Sexual dysfunction is common in people with MS, affecting an estimated 50–90% of men and 40–80% of women. It can have substantial impact on a patient’s self-esteem, relationships, and other aspects of health, all of which relate to quality of life.”

Lindsay Shapiro, PhD

Multiple Sclerosis: Intimacy & Sexual Dysfunction

Because of the direct effects of MS to the brain and spinal cord, there is a good chance that things may not work perfectly in the reproductive department. This could mean sexual dysfunction issues of varying levels are present in your life. For men, this might mean erectile dysfunction or ejaculation dysfunction. For women, this could mean vaginal atrophy or pain with insertion. The frequent body spasms and twitches may cause intimate situations to become stressful.
There are numerous ways to find, reach, and achieve pleasure and intimacy when the “usual” way no longer works. Here we will cover the most common issues reported by patients with MS covering sexuality, intimacy, and sexual function.
  • Mental Health, Intimacy, and Sexuality with MS. Depression, anxiety, feelings of failure, and the myriad of emotions that we have in our everyday lives all play a direct role in our ability to want or to be intimate with ourselves, or others. By practicing self-love, self-discovery, and working with a counselor or therapist, one can get back on the right path mentally, and see this flow into their everyday lives.(NIH)
  • Questions for your Doctor. Start slow, beginning by arming yourself with knowledge and power. These basic questions are a great place to start. Along with these questions, consider meeting with a sex therapist or counselor who is well-versed in the topic of intimacy and sexuality, practicing talk therapy, and being open to the idea of trying mental health medications, should your doctor suggest it.
  • “I am concerned about how MS might affect my sex life. What should I look for and how can I plan for these changes?”
  • “I have some questions about how MS might be affecting my sexuality.”
  • “I’m not sure how to talk to my partner about how MS has affected my sexuality. Where can I find resources to help? (National MS Society)”

  • Libido and Dysfunction. Libido is a touchy, fickle thing that can be “turned off” and “turned on” by external forces, mental and physical issues, and even simple day-to-day worry. Libido is the butterfly feeling in your belly when you think about being intimate with someone you desire. Sexual dysfunction occurs when something is hindering a person from finding feelings of pleasure or being able to utilize their sexual organs for achieving pleasure. There are many things that can hinder libido like: prescription medications, alcohol, drugs, cancer and long-term illness, surgical body alterations, and more.
    • Here are some options for people to try if they find themselves facing sexual dysfunction:
      • For Women: Vaginal Atrophy is one of the most reported problems women deal with in regards to vaginal health and dysfunction.
        • Lubrication to ensure that vaginal tissues are moist and pliable. A thick friction barrier will help to reduce pain and dryness.
        • Insertion pain? Consider dilator therapy. Dilators are designed to be inserted into the vagina and help to widen and tighten a tense vaginal opening.
        • Too tense? Try a dilator with vibration, or another basic vibrating bullet. These can help to relax tense muscles and provide pleasureful feelings while in use.
        • Struggling with daily dryness? Try a natural daily moisturizer. The more natural, the better! Chemicals, additives, and those “special features” (like “cooling,” or “tingling”) have many things in it that can be very damaging and irritating to the skin. (NIH/MSFocus)
  • For Men: Erectile dysfunction is the most reported problem men face regarding their sexual function, followed closely by loss of libido.
    • Use lubrication to ensure penile and genital tissues are not being damaged during masturbation or any other sexual act. Water-based lubrication provides a thin friction barrier, while silicone or silicone-hybrid lubrications provide a thicker, longer lasting friction barrier.
    • Consider the side effects of prescription dysfunction medications. There are many options on the market now, but all come with their own side effects. Think of your holistic options before putting more chemicals into your body.
    • Erectile dysfunction? You have many options!
      • Partial Ability? Using a support device, like a wearable extender, can help keep the penetrative action alive when you’re struggling to maintain a full erection.
      • Occasional trouble? Try a support ring, or cock ring, to help to hold the blood in the penile shaft, thusly making the erection fuller, longer lasting, and usable.
      • Unable to achieve an erection at all? No worries!
        • Self-Discovery & Masturbation Devices. There are specific items on the market designed for males facing erectile dysfunction. Masturbatory devices that can be used with one hand, or heated devices that provide a “sucking-like” action while warming.
        • Vacuum Penis Pump Devices. Penis pumps have been around for an exceptionally long time and offer a temporary solution to a possibly permanent problem. While air pumps are typically the standard when providing pump therapy to help restore lost penile function, water pumps are also on the rise– being a great tool for those men who have fragile, sore areas after facing cancer, surgery, or long-term illness. (NIH/MSFocus)
  • For Both Males and Females. These sexual dysfunction issues plague both men and women who are facing Multiple Sclerosis and many other health related issues.
    • Anorgasmia. This condition denies the person of being able to achieve an orgasm or must work very strenuously to achieve one. This can be a very discouraging condition to have when working to restore lost intimacy and function. This condition is annoying but is not dangerous.
    • Painful Intercourse. Pain with intercourse, insertion, or touch, can happen for a variety of reasons, causes, and conditions. If you are experiencing pain with intercourse, bring this up with your doctor at your next visit to ensure that you are bodily sound and not having some other sort of problem. Once cleared by your doctor, proceed slowly with getting to know your body again. Practicing self-discovery and masturbation can help you to find your trigger pain points to understand more how to work through intimacy issues. (NIH/MSFocus)

  • Incontinence. Bladder, Bowel, or Both. Incontinence is an unfortunate issue that many people will face in their lifetime for a myriad of reasons. There are many at-home therapies that can be done to help to increase pelvic floor health and strength, which can help to prevent and better control urine and bowel leakage. (NIH)
  • Muscle spasms. Muscle spasms go together with Multiple Sclerosis due to the brain and spinal cord involvement. If you find that your muscles are going into overdrive with intimacy or sexual acts, consider these tips:
    • Stretch before intimacy. By allowing your body to stretch, this can help to ease the built-up muscle tension you are holding in your body.
    • Try new positions for sex. For some, complicated positions, or those positions that stretch areas of your body where you struggle, will cause more stress on the muscles than needed. Start easy and slow- sticking with positions that are not complex or too difficult.
    • Medications. If you have anti-spasticity medications, follow your doctor’s guidance on when to take them before intimate or sexual activities.
    • Relaxation techniques. Practice positive mental health activities prior to being intimate or sexual. Allow yourself time to get out of your own head before trying to connect intimately with another. Yoga, deep breathing techniques, mental activities like HeadSpace can all help to calm the entire body, which can then help to ease the spasms. (NIH/MSFocus)
Those diagnosed with Multiple Sclerosis may experience changes in their sexual desires and intimate needs throughout the years with their illness. MS will indeed change the way you think about intimacy and sexuality, and the role that it plays in your life, but it will not limit you or make you miss out on intimate and sexual moments in your life.

Citations:

MSFocus.org

National MS Society

MultipleSclerosisNewstoday.com

HeadSpace App

Empowering Intimacy