MS can cause changes that affect a person's usual ways of expressing
sexuality. Everyone with MS retains the capacity to give and receive love
and pleasure, although creative problem-solving is sometimes necessary for some people in order to find avenues for intimate expression.
Understanding how MS symptoms
might affect intimacy and sexuality represents a crucial step towards
overcoming obstacles effectively. Whether one is newly diagnosed,
physically disabled, young, mature, single or in a committed
relationship, MS does not diminish the universal human need to give and
receive love and intimate pleasure.
The sexual partnership can be
challenged by changes within a relationship, such as one person becoming
the other's caregiver. Similarly, changes in employment status or role
performance within the household are often associated with emotional
adjustments that can temporarily interfere with sexual expression. The
strain of coping with MS may challenge a couple's efforts to communicate
openly about their respective experiences and their changing needs for
sexual expression and fulfillment.
Sexual changes in MS: frequency and characteristics
been completed on the prevalence of sexual and relationship problems in
MS in a number of countries. Although normal sexual function changes
throughout the lifespan, MS can affect an individual’s sexual experience
in a variety of ways.
Studies on the prevalence of sexual problems in MS
indicate that 40-80 per cent of women and 50-90 per cent of men have
sexual complaints or concerns. The most frequently reported changes in
men are a diminished capacity to attain or maintain an erection, and
difficulty having an orgasm. The most frequent changes that women report
are a partial or total loss of libido (sexual desire), vaginal
dryness/irritation, diminished orgasm, and uncomfortable sensory changes
in the genitals.
Sexual changes in MS can best be characterised as
primary, secondary or tertiary in nature. Primary sexual dysfunction
stems from changes to the nervous system that directly impair the sexual
response and/or sexual feelings. Primary disturbances can include partial
or total loss of libido, unpleasant or decreased
sensations in the genitals, decreased vaginal lubrication or erectile
capacity, and decreased frequency and/or intensity of orgasm.
sexual dysfunction refers to MS-related physical changes that indirectly
affect the sexual response. Bladder and/or bowel dysfunction, fatigue,
spasticity, muscle weakness, problems with attention and concentration,
hand tremors, and non-genital changes in sensation are amongst the most
common MS symptoms that can cause secondary sexual dysfunction.
sexual dysfunction results from psychosocial and cultural issues that
can interfere with sexual feelings and sexual response. Depression,
performance anxiety, changes in family roles, lowered self-esteem,
body image concerns, loss of confidence, and internalised beliefs and
expectations about what defines a “sexual man” or a “sexual woman” in the
context of having a disability, can all be expressions of, or contribute
to, tertiary sexual dysfunction.
The central nervous system and sexual response
response is mediated by the central nervous system – the brain and
spinal cord. There is no single sexual centre in the central
nervous system. Many different areas of the brain are involved in
various aspects of sexual functioning, including sex drive, perception of
sexual stimuli and pleasure, movement, sensation, cognition and
Sexual messages are communicated between various
sections of the brain, thoracic (upper), lumbar (middle) and sacral
(lower) spinal cord and genitals throughout the sexual response cycle.
Since MS can result in randomly distributed lesions along many of these
myelinated pathways, it is not surprising that changes in sexual function
are reported so frequently. The good news is that there are likely to be
neurologic pathways that mediate aspects of sexual feelings and response
that are widely distributed and therefore unaffected by MS lesions.
Read more in MS in focus - intimacy and sexuality