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Relationships, sexuality and parenting

Multiple sclerosis and sexual issues

The nerves of the central nervous system are sheathed in myelin, a substance that assists in nerve function. Multiple Sclerosis (MS) is a disease of the central nervous system that inflames the myelin and causes plaques or lesions to appear. The brain, spinal cord and optic nerves can be affected. The disease most commonly affects young white females living in temperate regions of the world.

The cause of MS is not known. It is thought that a virus may be the trigger. There is also genetic susceptibility. The two major forms of MS are relapsing-remitting and progressive. There is no cure, but there are treatments available that can modify the course of the disease and ease some of the symptoms.

A person with MS may be concerned about a number of sexual issues including function, fertility and pregnancy. It should be remembered that sexual problems are common, whether a person has MS or not. Seek professional counselling for further information and advice.

Changes in relationships

A person with MS may struggle to come to terms with their disease. They might fear for their future, or suffer from low self-esteem because of the physical changes they are experiencing. Their loved ones will also be emotionally affected, trying to deal with the diagnosis and its ramifications.

Stress, depression and anxiety can impact negatively on relationships by closing the lines of communication. The natural inclination when depressed is to withdraw from others, but this is a time when open and frank discussion is vital. The person with MS and their partner need to talk about the impact the disease is having on them and what changes might have to be accommodated in the future. For example, the person with MS may eventually be limited to working from home, or perhaps not working at all, which could put financial strain on the relationship. Other issues for consideration include sexuality and family planning.

Problems with sexual arousal

MS is a variable disease that can target virtually any part of the nervous system. The nerves servicing the reproductive organs can be impaired, which leads to changes in sexual functioning. Slowed arousal time is a common experience. Fatigue also dampens sexual desire. Physical problems caused by MS may only last as long as the attack, but emotional problems can linger. Many people with MS struggle with feelings of depression. This can impact on the quality of their close relationships and cause sex drive to dwindle. Open and honest communication is vital. Professional counselling and therapy may be necessary to help the couple come to terms with the challenges of MS.

Impotence can be treated

Some men with MS may become impotent, which is the inability to achieve or maintain an erection sufficient for sexual intercourse. This may be caused by the disease itself, side effects of certain drug therapies, or psychological problems (such as depression). Treatments can include counselling or may require the use of medications, which can be injected, taken orally or via mechanical devices such as vacuum pumps.

Changes in lovemaking

A person with MS may have symptoms that prevent them from enjoying sexual intercourse with their partner. However, a satisfying sexual relationship is much more than just penis-in-vagina sex. There are variations of lovemaking that the couple can explore together, such as oral sex, mutual masturbation and the use of marital aids.

For more information see: Sexuality and MS

Fertility and family planning

MS doesn't affect fertility. Contraception should be practiced (by either men or women) if the couple want to avoid pregnancy. Potential problems that need to be discussed, when planning for a family, include the partner's disease progression and whether they will feel physically capable of dealing with the demands of a child, both in the short term and in the years to come.

Genetic susceptibility

MS is not an inherited disease, but research suggests that genetic factors are involved. MS is far more common in people of Northern European ancestry. Ten to fifteen per cent of people with MS have a relative with the disease, but this may be a grandparent, an aunt, an uncle or a cousin. A child of a person with MS has a very small risk, around three to five per cent, of developing MS. Whilst genetic factors are important, they alone do not account for the development of MS; other, yet to be determined, environmental factors are also thought to play a part.

Pregnancy considerations

For a woman with MS, pregnancy doesn't impact on the long term course of the disease. Many women with MS find their attacks are less frequent during pregnancy. This is thought to be caused by pregnancy hormones dampening the activity of the immune system. However, most women find that MS relapses, or attacks are around two to three times more common than usual, in the first six months after childbirth. Child care assistance, either voluntary (from friends and family) or paid (babysitters and creches) is strongly recommended. MS doesn't influence childbirth or breastfeeding ability; however, if the woman is on an immunotherapy program, pregnancy and breastfeeding are not recommended. Particular drugs can be harmful to a developing baby. Be guided by your doctor.

For more information see: MS and pregnancy

Where to get help

Things to remember

Source - This page has been produced by The Better Health Channel in consultation with The MS Society. © The Better Health Channel 2001. Reproduced with permission.

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