Both men and women may experience sexual difficulties as the result of MS, which can include a loss of libido, altered genital sensation, and decreased frequency and intensity of orgasms. Men may experience difficulties with erection and ejaculation, and women may have reduced vaginal lubrication and pain during intercourse. Other symptoms of MS may also affect the ability to enjoy the sexual experience. Depending upon the cause of sexual dysfunction, a variety of pharmacologic and psychosocial approaches may be helpful.
Treatment of MS Symptoms that cause Sexual Difficulties
A number of symptoms associated with MS may affect sexual function and enjoyment. Identifying and treating these symptoms may also relieve what are termed secondary dysfunctions such as those that affect sexual function. These may include fatigue, depression, spasticity, pain, and bladder or bowel issues.
Counseling and Support
Open communication between partners is essential to managing sexual dysfunction. Both partners need to understand both the medical and psychological issues that can affect sexuality, and work toward open communication and the possibility of alternative approaches to sexual satisfaction.
A. Erectile Dysfunction
including Viagra® (sildenafil), Levitra® (vardenafil), and Cialis®(tadalafil)
These are oral medications in tablet form. Dosages are 50 to 100 mg per day (Viagra), and 5 to 20 mg per day (Levitra, Cialis). These agents were developed to manage erectile function due to many causes, but they have proved effective for many men with MS. They are chemically similar, and all delay the actions that interfere with developing and maintaining an erection.
Side effects may include headache, nasal congestion, and gastrointestinal symptoms.
Injectible Agents and Vacuum Pumps
Medications that are directly injected into the penis, including vasodilators and papaverine, are less frequently used.
Vacuum pumps are another alternative if medications are not feasible.
B. Vaginal Dryness
Lubrication agents, Estrogen-containing vaginal preparations, and topical creams
These may be prescribed for women experiencing vaginal dryness and/or genital sensitivity. Cold packs before intercourse can reduce sensitivity and muscle spasms.
Managing the Symptoms of Multiple Sclerosis, 5th Edition, by Randall T. Schapiro, MD; Demos Medical Publishing, 2007
Complementary and Alternative Medicine and Multiple Sclerosis, 2nd Edition, by Allen C. Bowling, MD, PhD; Demos Medical Publishing, 2007
These books and many others are available through MSAA's free Lending Library.
MSAA's MSi (Multiple Sclerosis information) online video program offers a variety of subjects through its A Closer Look series. Among others, topics include: managing various symptoms; MS fatigue; emotions; stress; intimacy; complementary and alternative medicine; and exercise.
Videos may be viewed for free by visiting mymsaa.org and selecting "MSi" video programs.