This article has been inspired by "Intimacy and Sexuality", issue six of the MSIF’s ‘MS in focus’ The content has been split over 3 articles.
Sexual complaints are common in the general population and are capable of having a profound impact on quality of life and relationships. Adding chronic illness to the picture makes problems more likely. Unfortunately these concerns and complaints are not always discussed with partners or health care professionals, but, strategies exist which can be used to cope with and manage symptoms, promote intimacy, strengthen relationships and encourage sexual pleasure and expression
Many symptoms of MS are invisible while others are painfully obvious. All can impact on quality of life and sense of wellbeing. While life changes affect everyone, changes from MS can directly and indirectly affect sexuality. Successful management requires creativity, communication, and patience so that a person is able to maintain his or her sexual identity.
Whether a person is in an intimate relationship or not, it is a challenge to maintain a sexual identity and take care of one’s sexual self-esteem (how one feels about oneself as a sexual being) while dealing with a chronic illness such as MS. This is particularly challenging in cultures where society places importance on qualities that are not always consistent with chronic illness, such as beauty, health and independence.
Sensory issues
Changes in sensation can interfere with sexual pleasure. Non-genital symptoms such as numbness and tingling can distract and discourage either partner. Impaired genital sensations can diminish pleasure, while heightened sensitivity may make even the lightest touch unbearable. What feels good at one time may be excruciatingly painful on another occasion.
Sexual changes in MS can best be characterised as primary, secondary, or tertiary.
Primary sexual dysfunction stems from changes to the nervous system that directly impairs the sexual response and/or sexual feelings. Primary disturbances can include partial or total loss of libido (sexual desire), unpleasant or decreased sensations in the genitals, decreased vaginal lubrication or erectile capacity, and decreased frequency and/or intensity of orgasm. This all sounds very matter of fact but to the person experiencing it, it can be devastating and even trigger a grief response for the major loss.
Secondary sexual dysfunction refers to MS-related physical changes that indirectly affect the sexual response. Bladder and/or bowel dysfunction make sex awkward or embarrassing, fatigue makes sex uninviting, spasticity and muscle weakness can make sex difficult if not impossible. Then there are problems with attention and concentration, hand tremors, and non-genital changes in sensation. Together these symptoms are amongst the most common MS symptoms that can cause secondary sexual dysfunction.
Tertiary sexual dysfunction results from psychosocial and cultural issues that can interfere with sexual feelings and sexual response. Depression, performance anxiety, changes in family roles, lowered self-esteem, body-image concerns, loss of confidence, and internalised beliefs and expectations about what defines a “sexual man” or a “sexual woman” in the context of having a disability, can all be expressions of, or contribute to, tertiary sexual dysfunction
In the following articles I will be addressing Female and Male sexual dysfunction separately
Kath Ibbetson has MS and was diagnosed in 1995. She qualified as a pharmacologist and then worked in computerized drug databases for 12 years. She has a BSc, a diploma in aromatherapy and a certificate in counselling. She follows drug developments cl
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