Multiple Sclerosis and Sex: Help for Men - dummies

Multiple Sclerosis and Sex: Help for Men

By Rosalind Kalb, Barbara Giesser, Kathleen Costello

If you’re a guy and you have multiple sclerosis (MS), you’re probably wondering what you can do to treat the different sexual changes that can happen because of the disease.

If you have difficulty getting or maintaining an erection, talk to your doctor because one of these medications may be helpful for you. Clinical experience indicates that they’re effective for about 50 percent of men with MS. Here are a couple of important things to keep in mind about these oral medications:

  • These medications don’t increase sexual desire or cause erections to happen. Instead, they allow an erection to occur when your penis is stimulated. In other words, these medications increase blood flow to the penis only after a sufficient amount of physical stimulation has occurred.

  • Even though each of these medications is readily available over the Internet, we strongly recommend that you consult with your physician before taking any of them. We say this because they can interact with other medications you may be taking. For example, if you take a nitrate medication such as Nitrostat or Transderm-Nitro to lower your blood pressure, Cialis, Levitra, and Viagra can cause your pressure to drop too far.

Injectable medications, such as Prostin-VR (alprostadil), papaverine, and Regitine (phentolamine), are another option for treating erectile dysfunction. When you want to have an erection, you inject the medication (with a very fine needle) into a point at the base of your penis that’s relatively insensitive (really, it’s not as bad as you’re thinking). Most guys describe the sensation as something like being flicked with a towel.

Unlike the oral medications, the injectables produce an erection within a few minutes, whether or not you feel aroused or your penis has been stimulated, so many men prefer this option. The erection usually lasts an hour or until you ejaculate.

When using an injectable medication, keep the following cautionary facts in mind:

  • Priapism (an erection that lasts too long) can occur with these medications. Adhere to the prescribed dose of medication and use it only as your doctor recommends — in this case, more isn’t better. An erection that lasts more than four hours can cause irreparable damage to your penis (so contact your physician immediately if you run into this problem).

  • Approximately 7 to 10 percent of men develop scarring (in the form of a small bump or nodule) at the injection site. However, proper training in injection technique greatly reduces this risk. If you develop scarring of this type, discussing it with your doctor is important so that you can be appropriately treated, because progressive scarring can lead to a curvature of the penis. Luckily though, the nodule usually disappears after you stop using the injections.

Other options for managing erectile dysfunction include surgically implanted penile prostheses that work mechanically rather than chemically or a vacuum tube that creates a vacuum around the flaccid penis to produce an erection.