Therapies Are Available to Treat Sexual Problems of MS

There are a variety of therapies to treat sexual dysfunction. 

For men, erectile dysfunction may be addressed through use of the oral medications Viagra® (sildenafil), Levitra® (vardenafil), and Cialis® (tadalafil); injectable medications such as papaverineand phentolamine that increase blood flow in the penis; the MUSE® system which involves inserting a small suppository into the penis; inflatable devices; and implants.

For women, vaginal dryness can be relieved by using liquid or jellied, water-soluble personal lubricants, which can be purchased over-the-counter. It is a common mistake to use too little of these products. Specialists advise using them generously. Petroleum jelly (Vaseline®) should not be used because it is not water-soluble and may cause infection.

Both men and women with MS and their partners can benefit from instruction in alternative means of sexual stimulation, such as the use of a vibrator, to overcome slow arousal and impaired sensation. Abnormal sensations and spasms can often be controlled through use of medication. Techniques such as intermittent catheterization or medication can control urinary leakage during intercourse.

MS does not affect the basic fertility of either men or women, although sexual problems may interfere with the ability of a man with MS to father a baby. “Dry orgasms,” that impair fertility, have been reported by men with MS in several studies. These problems have been successfully treated with medication or through techniques to harvest sperm for insemination. Men who are concerned about fertility issues should consult a urologist experienced in this area.

Women and men with MS are also advised that they must make the same decisions and take the same precautions regarding birth control and sexually transmitted diseases as anyone else.

The emotional factors relating to changes in sexual function are quite complex. They may involve loss of self-esteem, depression, anxiety, anger, and/or the stress of living with a chronic illness. Counseling by a mental health professional or trained sexual therapist can address both physiologic and psychological issues. This therapy should involve both partners.

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