Many people think that a diagnosis of MS means sexual life has ended, however, sexuality does and should continue to be an important part of life for people with MS. However, the majority of both men and women with MS report problems with sexuality. Men report impaired genital sensation , decreased sex drive, inability or difficulty in achieving and keeping an erection, and delayed ejaculation or decreased force of ejaculation. Women report impaired sensation, diminished response, loss of interest, intense genital itching, less vaginal lubrication , weak vaginal muscles, and leg spasms.

Specific issues

• Bowel, bladder, catheter problems: Fluids should be reduced two hours before sexual activity and the bladder should be emptied.
• Spasticity or leg spasms: Spasticity and leg spasms can be minimized by timing medication for its maximum effectiveness during sexual activity (usually an hour or so prior to sex). Having intercourse in a side position may lessen this problem.
• Lubrication difficulties: Lubrication can be increased by using lubricants such as KY jelly, Replens or Astroglide.
• Problems with erections: Viagra may allow for a good erection if it is taken by mouth an hour before intercourse. There are also surgical penile implants available, as well as injectable medications that can create erections. A newer alternative involves using an applicator to put medication into the opening of the penis to create a stronger erection. There are also penile vacuum devices that are able to produce an adequate erection. Urology consulation is often helpful in managing this problem.
• Ejaculation problems: While no medication has been proven to stimulate ejaculation, the antidepressant Trazodone has been reported to be helpful for some men when used one hour before intercourse.

See also

MS Sourcebook
NMSS intimacy pages