How to Have a Healthy Sex Life When You Have Multiple Sclerosis

ByMadeline R. Vann, MPH, LPC
Updated on February 19, 2025
Medically Reviewed byJason Paul Chua, MD, PhD

Multiple sclerosis (MS) is a chronic disease that affects your central nervous system: your brain, spinal cord, and optic nerves. It can also affect your sexual function and desire.

Research shows that 50 to 90 percent of men and 40 to 80 percent of women with MS experience some kind of sexual dysfunction.

Those statistics may seem daunting, but once you understand how MS leads to challenges with sex, you can focus on regaining your enjoyment of sexual intimacy.

How MS Impacts Sexual Function

Sexual arousal begins in the central nervous system, with the brain transmitting signals to the sexual organs via nerves in the spinal cord. If the brain lesions that are characteristic of MS interfere with the connection between the brain and the sexual organs, it can result in sexual dysfunction.

Psychological issues that often accompany MS — such as depression, stress, and problems with body image — can also impact your sex life.

Physiological Effects of MS on Sexuality

MS can directly affect your sexual response and function if it damages the nerves that carry messages from your brain to your sexual organs, says Nicholas G. LaRocca, PhD, a clinical psychologist who specializes in MS and is a consultant for the National Multiple Sclerosis Society (NMSS).

Other MS symptoms, such as fatigue, spasticity, and abnormal sensations, can also dampen desire.

For men, the sexual side effects of MS can include:

• Difficulty achieving or maintaining an erection
• Reduced sensation in the penis
• Difficulty ejaculating

In women, sexual challenges in MS may involve:

• Reduced vaginal and clitoral sensation
• Painful sex
• Vaginal dryness

Both men and women may have trouble becoming aroused and reaching orgasm.

Indirect Effects of MS on Sexuality

Common psychological symptoms of MS, including stress, anxiety, and depression, can impact your libido.

You may also feel self-conscious if your body looks or feels different.

“Many individuals with MS no longer see themselves as sexually desirable, and this negatively impacts their sex lives,” says Donna Graves, MD, the specialty medical director of neurology at Atrium Health Neurosciences Institute in Charlotte, North Carolina.

Some MS symptoms may be so personal or embarrassing that you have a difficult time telling your partner about them and decide to avoid sex altogether. “Bladder and bowel control problems can present some fairly significant challenges,” Dr. LaRocca says. “Those kinds of symptoms are not directly related to sexual machinery, but can interfere with interest and ability to participate in sex. One of the biggest losses is that loss of spontaneity.”

How MS Affects Sexual Desire in Women

Women with MS may have some unique challenges with reduced sex drive. Research suggests these factors play a large part in female libido:

Interpersonal conflict

• Poor communication with their partner
• Self-image

When women feel chronic pain, fatigue, and stress with MS, it can affect their sex drive more than it does in men with the same diagnosis.

Medical Treatments to Improve Sexual Function With MS

Your healthcare provider can advise you on medical treatments that may improve sexual function and desire with MS. “Sexual health is an essential yet often under-discussed component of overall well-being for individuals with MS,” says Achilles Ntranos, MD, an MS neurologist in Los Angeles.

A good starting point is to address MS symptoms, he adds. “Optimizing a patient’s MS therapies — like adjusting disease-modifying treatments, fine-tuning spasticity medications … and managing neuropathic pain — can often improve comfort and sexual satisfaction.”

Here are some recommended treatments.

Medications for Erectile Dysfunction Medications for erectile dysfunction include sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). “These medications help increase blood flow and can be very effective,” says Dr. Ntranos.

Penile Implants Men who experience erectile dysfunction can also choose to use penile implants to assist with erections. Options include an inflatable penile prosthesis and a semi-rigid prosthesis, both surgically implanted.

Testosterone Men can take testosterone as a cream, gel, skin patch, or injection.

“Hormone replacement (under careful supervision) may improve sexual desire and energy levels,” says Ntranos.

Estrogen Some medications for hormone replacement in women increase estrogen or mimic its effects. These include oral medication and creams, rings, or tablet inserted into the vagina.

Antispasticity Medication Taken 30 minutes before sexual activity, some medications can lessen spasms during the encounter. These include baclofen (Lioresal, Lyflex), tizanidine (Zanaflex), gabapentin (Neurontin), and diazepam (Valium).

Intermittent Catheterization Emptying the bladder with an intermittent catheter (which you only use when needed) before sex can help control urinary leakage during intercourse.

Pelvic Floor Exercises A physical therapist can teach you how to strengthen the muscles in your pelvis, which play a big role in sex.

Other Ways to Regain Your Enjoyment of Sex

In addition to medical treatments, there are other ways to experience pleasure and intimacy. 

Read more by clicking here