Sexual Dysfunction Problems - National Multiple Sclerosis Society

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Sexual Dysfunction Problems

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In this article

Overview

Sexual dysfunction is common in people with MS and is important to assess because patients may be relunctant to self-report

The Psychosocial Implications for sexual dysfunction symptoms are:

Individual:

  • Significant impact on gratification, self-esteem, self-confidence; difficult/embarrassing to discuss with healthcare providers

Interpersonal:

  • Significant impact on all intimate relationships:
    • Sexual activity can be difficult, exhausting, painful, and unsatisfying
    • Lack of arousal can be misunderstood and resented by partner
    • Learning new ways to be intimate can be frightening and difficult
    • Caregivers may become disinterested in, or uncomfortable with, their disabled partner
    • Person with MS may be reluctant to become intimate with new partner

Symptom: Primary (result of neurologic impairment)

Description

  • Impaired arousal; sensory changes; reduced vaginal lubrication; erectile dysfunction; inability to achieve orgasm

Treatment

Interventions:

  • Education; evaluation; counseling; sexual aids to enhance stimulation

Medications:

  • Men:
    • Oral medications: sildenafil, vardenafil, tadalafil;
    • Injectable or insertable medication: alprostadil
    • Prosthetic devices
  • Women:
    • Lubricating substances; enhanced stimulation

Symptom: Secondary (resulting from other MS symptoms)

Description

  • Fatigue; spasticity; bladder/bowel problems; sensory changes interfere with sexual activity.

 
[Note: Impaired arousal, erectile dysfunction, and inability to orgasm can also result from medications taken to relieve other symptoms, most notably antidepressants.]

Treatment

Interventions:

  • Evaluation of medications that might be interfering with sexual function
  • Effective management of other MS symptoms [link to sx management page] to reduce impact on sexual function

Symptom: Tertiary (resulting from disability-related attitudes/feelings)

Description

  • Feeling unattractive; unable to attract a partner; believing that sexuality is incompatible with disability

Treatment

Individual and couple’s counseling and education

Resources for clinicians

Resources for patients

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