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Joe feels a shiver of anticipation as he waits in bed for his wife, Beth. They just had a superb candlelit Valentine’s Day dinner, and now he is imagining the moments of intimacy ahead. And yet…he’s incredibly tired, has been all week. And he knows that the last few times they’ve made love, it seemed to take more work to achieve an erection…which didn’t last very long. But when Beth comes to him, Joe opens his arms, wraps himself around her, and kisses her passionately. A half hour later, he still has not achieved an erection.
Joe has MS. It is just one of many diseases and disorders that can cause sexual problems like erectile dysfunction. MS brings an unusually high risk of these problems, and it affects both men and women—as many as 91% of men and 72% of women with MS reportedly experience sexual difficulties, whether they arise from physiological, mechanical, psychological, or emotional factors.
In a recent survey, 63% of people with MS said their sexual activity had declined since their diagnosis. The hope is that with education and advice, these people and others like Joe and Beth will choose not to ignore or accept sexual dysfunction. They have a growing array of options available to treat or circumvent problems so they can enjoy a satisfying sex life.
The Source and Nature of Sexual Problems in MS
MS is a disease of the brain, which is also where sexual excitement begins. Electrical signals that convey arousal and orgasm travel between the brain and the genitals in long, complex pathways in the spinal cord and pelvis. In the presence of MS, these pathways are vulnerable to demyelination, the process by which MS damages the coverings of nerve fibers in the brain and spinal cord. If that occurs, the brain-genital transmissions may begin to short-circuit. The sexual changes that result include the following.
- In women
– Loss of libido and sex drive
–Vaginal dryness
–Trouble achieving orgasm
– Reduced sensation or painfully heightened sensation in the vaginal or clitoral area
- In men
– Loss of libido and sex drive
– Difficulty achieving and maintaining an erection
– Difficulty achieving orgasm and/or ejaculation
– Reduced sensation in the penis
