Sexual Dysfunction and Multiple Sclerosis

In the presence of sexual stimulation, nerves in the spongy tissue of the penis release the chemical nitric oxide, stimulation the production of something called cyclic GMP which relaxes the smooth muscle in the penis, compressing the veins. Causes of impotence are many and include heart disease, high cholesterol, high blood pressure, obesity, metabolic syndrome, Parkinson's disease, Peyronie's disease, substance abuse, sleep disorders, BPH treatments, relationship problems, blood vessel diseases (such as peripheral vascular disease and others), systemic disease, hormonal imbalance, and medications (such as blood pressure and heart medications). Pay your bill online, these drugs work by enhancing the action of nitric oxide in the body, increasing smooth muscle relaxation in the penis. It is probable that our sample would have lower levels of SD than other studies given that our sample was notably young, educated and had a lower level of disability [25].

Therapists can also help couples talk openly with each other about their sexual concerns and needs. Some men experience chronic, complete erectile dysfunction known as impotence, and others, partial or brief erections. The tube is then removed. A ring is then placed around the base of the penis to maintain the erection created.

  • Men may experience difficulty achieving or maintaining an erection and a decrease in or loss of ejaculatory force or frequency.
  • Primary, secondary and tertiary dysfunction help to recognize and present possible solutions should they exist to the complex sexual problems associated with MS.

2% of participants endorsed sexual dysfunction symptoms that were present always or almost always in the previous six months. Ageing - difficulties with erections are more frequent in older men. It has been stated some 70% of men living with MS experience erectile issues and they tend to begin several years after the initial symptoms of multiple sclerosis but this is not always the case. Brands, at the beginning of a session, a hypnotist will count you down. If the screening is positive for sexual dysfunction symptoms, the practitioner can then follow up and inquire whether the patient would like help with these symptoms.

Depression is another psychological disorder seen frequently in people with MS that often impacts sexual function. If these pathways are disrupted by plaques, sensation and orgasmic response can be diminished or absent. Chiaravalloti ND, DeLuca J. She was happily married for 25 y, reported a healthy sex life, but this behavior was completely atypical. Both men and women may experience hypersensitivity or reduced sensation in the genital region, and both may have trouble reaching orgasm. Why is this important?

However, in women with significantly reduced sensation, EMG biofeedback is required to help them identify and contract the appropriate pelvic floor muscles in the prescribed manner.


MS-related fatigue or depression can have a libido-dampening effect, as can pain, odd sensations — such as pins and needles or tingling — in parts of your body, or spasticity in your muscles. Hormonal, tiefer L (2020) Female Sexual Dysfunction:. All patients should be evaluated by their physician to be sure they are healthy enough for sexual activity. On this basis, PwMS may also be advised to engage in sexual activity earlier in the day to reduce SD due to fatigue [41]. Even if people are referred for sex therapy, often the waiting list can be six months or longer due to limited availability. For women who have difficulty with lubrication, a nonpetroleum-based lubricant may reduce vaginal dryness, while use of a vibrator may assist with genital stimulation. Such messages may move more slowly or they may not reach their destination at all. Sex therapy This form of therapy focuses specifically on sexual problems.

This can result in a slowing or blockage of the impulses sent from the brain to the body and back. Hot or cold therapy, biofeedback, and electrical stimulation may also help with mobility limitations or spasticity. “Sizing up Sexual Symptoms” in Multiple Sclerosis for Dummies. The first step in management of sexual dysfunction is to acknowledge that sexual dysfunction is a significant health care problem that most people with MS face at some point in their lives. When this happens, the lines of communication between nerves can be severely affected. A Double Blind, Randomized Study of Sildenafil Citrate for Erectile Dysfunction in Men with Multiple Sclerosis. Intimacy may be defined as anything that makes one feel closer to another, particularly in a personal and private way. Vasocongestion refers to the concentration of blood in the blood vessels and the tissues of the genitals and breasts.

The exclusion criteria were:

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Erectile dysfunction can be a sign of a physical, psychological or neurological condition. The diagnosis of MS, combined with the unpredictable nature of relapses and the uncertainty of disease progression, often occurs at a time when dreams and plans for the future are being formulated and relationships and careers established. If all else fails, a penile prosthesis can be implanted so that cylinders implanted into the shaft of the penis can be filled from a fluid reservoir in the scrotum. Psychogenic erections involve visual or auditory inputs that interface with the cortical organizing regions of the brain, whereas reflexogenic erections involve genital sensory stimulation through a spinal cord reflex.

Masturbation did not always result in orgasm, and it was generally not satisfying. Nocturnal erectile activity was normal in 11 patients, of whom nine had abnormal PEP and/or BCR. Adult skin conditions, this study did not directly compare Cialis versus tamsulosin. It is important to recognize and understand this symptom in order to adequately address it.

Understanding the type of pain can influence the best way to manage it. They work by enhancing blood flow into the penis, which leads to the penis becoming rigid and erect. Muscle weakness may necessitate alterations in sexual practices. Testosterone is active in several brain centres important for sexual thoughts and desire (libido) and low levels of it are associated with depression and obesity, both of which can relate to MS. If necessary albeit difficult reach out to seek some professional guidance or mediation. Controlling your weight is key to lowering stroke risk. Occupational therapists can instruct people in the use of sexual devices that can enhance sexual pleasure.

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This content originally appeared in the Summer/Fall 2020 and Winter/Spring 2020 issues of The Motivator. Diminished libido is frequently associated with a decrease in sexual fantasies and can sometimes be stimulated by increasing sexual imagery and fantasy. Copyright, methods for reversing ED fall into three categories:. Create a stimuli-saturated, minimally-distracting environment. Different positions help some men to be more stimulated and some benefit from mechanical assistance, e. Discussing new positions and various expressions of sexuality, such as massage or oral sex, can add excitement to the relationship and boost, rather than diminish, self-image. A high disability score corresponded poorly with both reduced sexual function, insufficient nocturnal erectile activity, and abnormal PEP and/or BCR. Treatment of any underlying depression and anxiety may require medication and psychological counselling and the provision of ongoing monitoring and support.


Unfortunately, no existing treatments exist specifically targeted towards these problems in MS. But, there are steps that can be taken to improve sexual function and intimacy , despite MS. Arguing, negative emotions such as anger and frustration when speaking about love and intimacy push people apart when they become heated or hurtful. Here you can discuss topics, perhaps seen as too embarrassing to discuss alone, in an open and supportive atmosphere. This exact correlation was also observed by Lew‐Starowicz and Rola (2020). When loss of desire is due to secondary sexual dysfunction (for example, as a result of fatigue) or tertiary sexual dysfunction (for example, as a result of depression), treatment of the interfering secondary or tertiary symptoms frequently restores libido. All of the reasons mentioned above may lead to the idea that the analysis of factors associated with SD in this very particular group of patients may result in achieving practical clinical benefits.

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Most men will experience some form of impotence in their lifetime, and the likelihood of developing symptoms increases with age and declining health. This may be true for care partners also. Not all men with ED (or even health professionals) find it easy to talk about it, and they may not raise this distressing issue. The well partner may misunderstand this “disinterest” and loss of pleasure and resent the person with MS. “Penile implants are not advisable for patients with neurological disease, because they tend to erode over time and they are more likely to erode if sensation is impaired,” she said. A significant relationship was found between SD and the presence of physical disorders impeding sexual activity, in particular fatigue [20], and although reported by people with a range of chronic disease, appears to be a particular problem for PwMS [7].

Overall, 104 men (mean age, 45; EDSS, 3. )The hand pump produces vacuum pressure, and the band constricts the veins. Ejaculatory dysfunction is managed through penile vibratory stimulation and midodrine. However, there are reports that sex therapy combined with MS symptom management and communication skills training, can be successful. Do not be afraid to seek professional help within your health care team in respect to addressing sexual dysfunction. Sex therapy is another option for men and women with MS along with their partners.

Erectile Dysfunction Treatments in Ridgeland FAQs

Sexual activity for men usually requires the co-ordination of arousal, penile erection and orgasm including ejaculation, along with the many other emotional and relationship components that are integral for satisfaction. Men commonly are afflicted with problems in achieving or maintaining an erection. ” This has caused financial difficulties for her family. Recognizing and treating the underlying cause is the best way to enhance intimacy. A drug cocktail, spiked pills have turned up in Thailand, Taiwan, Canada, Australia, New Zealand, Hong Kong, Malaysia, the United Kingdom and the United States, according to testing done by Pfizer Inc. Primary sexual dysfunction is a direct result of neurologic changes that affect the sexual response. There are three ways that MS patients can be affected by sexual dysfunction, and they are categorized as primary, secondary, and tertiary. Pain during intercourse is also a frequently reported symptom in women with MS, which may be due to vaginal dryness, spasticity or sensitivity.

Sexuality is an important aspect of human life and must not be neglected when considering the impact of MS on an individual. Advanced methods of assisted reproduction may sometimes be the only option for conception. Medications and substances that may cause or contribute to erectile dysfunction. Graves notes that several available treatments can improve sexual function and help rekindle romantic feelings. Although smoking showed significant unadjusted associations with our outcomes, in the final regression models, it did not reach a significance level of <.

In order to address these problems as one would address other symptoms, they first must be recognized and discussed. In type 2 diabetes, another chronic disease with strong lifestyle associations, intensive lifestyle intervention in obese women resulted in a significantly greater proportion remaining sexually active, improvements in sexual function, and greater likelihood of remission of SD at 1 year [43]. Many patients are on SSRIs or other drugs that frequently contribute to loss of libido and sexual dysfunction. This seems especially true for younger men with MS who have no other known contributing factors to ED. Simple blood tests to exclude diabetes, high cholesterol and testosterone deficiency are recommended. Generally safe, these drugs may cause mild headaches, flushing, nasal congestion, indigestion and muscle aches, but these side effects usually do not preclude their use. CH Polman, AJ Thompson, TJ Murray, AC Bowling, and JH Noseworthy.