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How Multiple Sclerosis Affects Intimacy and Sexual Health


The National Multiple Sclerosis Society acknowledges that sex and gender exist on a spectrum, that they are not binary. For the purposes of this page, we will use the terms “man” or “woman” to refer to a person’s gender assigned at birth.

In this article

Sexual Problems and Multiple Sclerosis

Numbness, vaginal dryness, erectile dysfunction and loss of libido: these are some of the ways that multiple sclerosis can impact your sex life. In addition to  physical changes, you may also be coping with fatigue, pain and depression — not to mention the stresses that a chronic disease can place on a relationship.

To complicate matters, it can be uncomfortable to talk about these issues with a healthcare provider or even with your partner. But there are ways to maintain intimacy with multiple sclerosis and to have a healthy sex life. Read on to learn about the physical and emotional changes you may be experiencing, how they might be affecting your sex life and what to do about them if they are.

Physical Changes Due to MS That Affect Sexual Function

Sexual arousal begins in the central nervous system, as the brain sends messages to the sexual organs along nerves running through the spinal cord. If MS damages these nerve pathways, it creates a disconnect between your brain and your sexual organs. This can affect your sexual response. The symptoms of this look slightly different in those assigned male and assigned female at birth.

How Does MS Affect Men Sexually?

Possible effects include altered genital sensation (numbness, pain, increased sensitivity), a delay or inability to achieve orgasm, and a delay or inability to ejaculate.

How Does MS Affect Women Sexually?

The most common problem for women with MS is low desire, but they may also experience issues with lubrication, lack of sensation, difficulties with arousal, difficulties reaching orgasm and sexual pain.
In addition to dealing with these primary physical symptoms, both women and men may also be frustrated by other physical MS symptoms — ones unrelated to the sex organs. These secondary symptoms include fatigue, spasticity, physical pain, and bowel and bladder issues.

How Does MS Affect LGBTQ+ People Sexually?

LGBTQ+ people living with MS will also be impacted by nerve damage, MS-related fatigue and bladder issues. In addition, members of the LGBTQ+ community may have a different experience with accessing healthcare in general and sexual healthcare in particular. For instance, according to a 2020 study, people with MS who identify as LGBTQ+ reported lower comfort levels in discussing sexual health with their healthcare provider. Read one activist’s story about getting diagnosed and their advice for enacting change.

Emotional Changes Related to Sexual Function

Many emotional factors contribute to sexual dysfunction in those living with MS. These may include depression, anxiety, anger, decreased self-esteem and the stress of living with a chronic illness. MS may have shifted the roles and responsibilities within your relationship, disrupted your plans and expectations for the future, and made it harder to share uncomfortable feelings and fears.

Counseling — for you and your partner — by a mental health professional or trained sexual therapist can address both psychological and physiologic issues. The Find Doctors & Resources tool can help you find a therapist and our guide to mental healthcare includes tips for screening providers to locate one who fits your needs.

Resources for Improving Your Sex Life

Sex Life and MS

An MS diagnosis doesn’t have to mean the end of a satisfying sex life.

Watch the Video

Watch the Video

Intimacy and Sexuality in MS

Learn more about potential issues and how to address them.

View the Guide

View the Guide

Let’s Talk About Sex

Dr. Linda Mona leads a discussion on how MS can affect sexual feelings and functions.

Watch the Webinar

Watch the Webinar

Treating Sexual Dysfunction Due to MS

All people living with MS may experience difficulty achieving orgasm or loss of libido. You and your partner can benefit from instruction in alternative means of sexual stimulation to overcome slow arousal and impaired sensation. Medication can help you manage abnormal sensations and spasms. Techniques such as intermittent catheterization or medication can control urinary leakage during intercourse.

Treating Sexual Dysfunction in Men With MS

The most common sexual problem for men is difficulty achieving or maintaining an erection. Erectile dysfunction may be addressed through:

  • Medications to increase blood flow to the penis
  • Injections of papaverine, a vasodilator, into the penile shaft, to cause blood vessels to expand, allowing more blood to enter the penis
  • MUSE (alprostadil) urethral suppository, a medicine that’s inserted with an applicator directly into the urethra (penile opening), stimulating erectile tissue, enlarging arteries for greater blood supply and preventing blood from leaving the penis to help maintain erection
  • Penile vacuum pumps to increase blood flow mechanically

Some medications used to treat sexual dysfunction can negatively affect other, comorbid conditions or interact with other medications. Discuss these options with your provider before trying them.

Treating Sexual Dysfunction in Women With MS

Women may experience reduced sensation in the vaginal/clitoral area, painfully heightened sensation and vaginal dryness. Management strategies include:

  • Vibrators to increase stimulation and arousal
  • Clitoral pumps, which suction around the clitoris and assist with vaginal arousal
  • Liquid or jellied, water-soluble personal lubricants for vaginal dryness (avoid petroleum jelly —Vaseline® — because it is not water-soluble and may cause infection)
  • AddyiTM (flibanserin), a medication to boost the release of the pleasure hormones dopamine and norepinephrine and tamp down serotonin, which can decrease sexual interest and pleasure if released in the wrong place at the wrong time

Some medications used to treat sexual dysfunction can negatively affect other, comorbid conditions or interact with other medications. Discuss these options with your provider before trying them.

Read more about the effects of MS on sex and how to address any challenges in Momentum Magazine.


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