Multiple Sclerosis: Tips for Keeping Your Sex Life Healthy

If you have multiple sclerosis (MS), those symptoms may be getting in the way of your sex life. If this is the case, do what you need to do to take care of them. Consider the following problems (and solutions):

  • Fatigue can put sex on the bottom of your priority list. However, managing your fatigue effectively will give you more energy to get it on. Try to plan sexual activity for times of the day when you have more energy — even if it means getting up a little earlier in the morning to make time before the busy day begins.

  • Stiffness or spasticity can interfere with comfortable positioning. Flexibility is key to whatever acrobatics you might enjoy. You can do stretching exercises or use medications to relieve your spasticity and loosen up your limbs.

  • Bladder problems can put a damper on sexual activity. To avoid embarrassing accidents (and to allow yourself to relax and be in the moment), empty your bladder or catheterize yourself before you have sex. Although some partners find the prospect of urinary accidents pretty uncomfortable, most take it in stride after they understand what the problem is and what you’re doing to take care of it.

  • Weakness can make sexual activity difficult and tiring. For example, being on top may feel much more tiring than lying on your back, or lying on your side may be the most restful of all. Experimenting with different positions to find out what puts the least strain on weakened muscles is a good idea.

    This is one of those situations where it helps to think creatively — just because you’ve always had sex one way doesn’t mean it’s your only option. Who knows what you might discover!

  • Cognitive changes can cause you to be distracted, which in turn makes it difficult for you to become or stay aroused. So, create a sensual, distraction-free environment for sex. Unless you’re watching a great sexy movie that turns you on, shut off the TV. Do whatever feels most soothing and sensual with the lights, and make sure you aren’t going to be interrupted or distracted by goings-on in the house.

MS and sex: get help from your doctor

If you think your medications are getting in the way, the best place to start is with a conversation with your doctor. Sometimes changing the dose or the timing of the dose is possible in order to relieve a problem you’ve been having. For example:

  • If you’re taking a bladder medication that causes vaginal dryness or pain, or if you’re taking spasticity medication that makes you very tired, the doctor may change the dosing schedule to make you more comfortable for sexual activity.

  • If you’re taking an antidepressant that interferes with sexual arousal or orgasm, you may be able to skip a dose before sex. Although skipping a dose is definitely not recommended at the beginning of a major depressive episode, it can work well for someone who has been comfortably stable on an antidepressant for several weeks or months.

Adjusting your medications is possible, but only after talking with your doctor. Varying from a doctor’s prescribed instructions could lead to serious health complications.

MS and sex: talk to a therapist

If your head is getting in the way — you’ve lost your self-confidence, you don’t feel attractive any more, you’re too worried or preoccupied to think about sex these days, or your partnership is under so much strain that sex isn’t high on the priority list — chatting with a mental health professional can be wonderfully helpful.

Sex is about more than just a few body parts, and intimacy is about more than just sex, so fixing those parts is only half of the solution to MS-related sexual changes. If you’re having trouble communicating, trusting one another, or dealing with whatever changes the MS is causing in your relationship, chances are that all the Viagra or Astroglide in the world won’t solve the problem.

So, don’t be too bashful about talking with a couple’s therapist if things are dicey — he or she can help you get back on track.

MS and sex: help from other resources

Here are some great books (with lots of pictures) to help you get your groove back:

  • Sex For Dummies, third edition, by Dr. Ruth K. Westheimer with Pierre A. Lehu (John Wiley & Sons)

  • Guide to Getting It On, sixth edition, by Paul Joannides (Goofy Foot Press)

  • The Ultimate Guide to Sex and Disability by Miriam Kaufman, Cory Silverberg, and Fran Odette (Cleis Press)

  • Enabling Romance: A Guide to Love, Sex, and Relationships for the Disabled (and the people who care about them) by Ken Kroll and Erica Levy Klein (Woodbine House)

  • The Good Vibrations Guide to Sex, third edition, by Cathy Winks and Anne Semans (Cleis Press)

Also, take a look at the website for Good Vibrations, a company in California that specializes in sexual health and pleasure. Good Vibrations has three locations, a website, and a catalog. The website offers disability-related information and an online magazine that features a column about sex and disability.

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