As many as 75 percent of people with MS may experience periodic sexual dysfunction as a result of MS lesions. The body’s primary sex organ is the central nervous system, where all sexual response begins. The short-circuiting of messages from the brain, caused by MS lesions, can result in decreased genital sensation, pain, and/or dryness in women. Men may experience decreased sensation and erectile problems. In either gender, fatigue, sensory changes, weakness, spasticity, tremors, bowel and bladder problems, and cognitive problems can also interfere with sexual function.
Sexual problems often have a psychological as well as a physical component. MS can contribute to low self-esteem, decreased communication in a relationship, lack of intimacy, depression and anxiety. All of these can have an impact on sexual functioning. A comprehensive evaluation is often needed to sort out the various issues.Sexual arousal begins in the central nervous system, as the brain sends messages to the sexual organs along the nerve pathway in the spinal cord.
The following symptoms can occur as a direct result of myelin breakdown in the spinal cord or brain:
- Change in genital sensations (increased or decreased sensitivity, pain, etc)
- Difficulty or inability to maintain erection
- Vaginal dryness
- Decreased sex drive
- Decreased vaginal muscle tone
- Ejaculation difficulty
- Problems having an orgasm
- Fatigue can suppress sexual desire
- Spasticity can interfere with positioning or cause pain
- Sensory changes can make physical contact uncomfortable.
Psychological Impact of Multiple Sclerosis on Sex
A loss of interest in sexual contact or intimacy may arise as a result of psychological or social issues associated with multiple sclerosis, such as:
- Performance anxiety
- Changes in self-image or body image as a result of disability