ARTICLEMS

You Can Have an Enjoyable Sex Life with MS—Here’s How

By Kerry Weiss

Reviewed by Dana Cooper, M.D.

January 26, 2024

Multiple sclerosis (MS) can come with a range of symptoms, such as fatigue, numbness, tingling, spasticity, and walking difficulties. One symptom that often doesn’t get talked about enough? The impact MS can have on a person’s sex life.

When certain nerve pathways are damaged by MS, it can result in problems with sex drive and sexual function. Symptoms like spasticity, fatigue, bladder or bowel issues, and cognitive changes can also affect a person’s sex life. And living with a chronic condition like MS can take an emotional toll, leading to stress and lowered self-esteem, which can play an indirect role in harming intimacy.

If you’re experiencing issues in the bedroom, you’re not alone. Results from a 2016 international study of more than 2,000 people living with MS found that the majority reported at least one issue related to sexual function and expressed a lack of satisfaction with their sex life.

7 Tips for a Better Sex Life with MS

Having a sex life that feels healthy and enjoyable is important for many people. The good news? There’s plenty you can do to help get your groove back. Start with these steps.

Open Up to Your Doctor

Despite how common sexual dysfunction is in people with MS, it’s often left underreported and unaddressed. That’s probably because it can feel uncomfortable or embarrassing to talk about.

Still, it’s important to discuss with your healthcare team any sexual issues that come up, first and foremost. “It contributes to your quality of life,” says Kalina Sanders, M.D., a board-certified neurologist specializing in MS and spasticity management at Baptist Health in Jacksonville, Florida. “So, if there are ways in which we can facilitate or help to provide some assistance with improving that aspect of your life, then obviously you’ll be much happier.”

Your doctor can help you determine whether your issues are caused directly by your MS symptoms or something else, and then you can work together to address the root cause.

Address the Symptoms of Sexual Dysfunction

Anyone living with MS may experience issues like libido changes or difficulty having an orgasm. “It can affect both men and women very similarly,” Sanders says.

Some men may also experience erectile dysfunction, or difficulty achieving or maintaining an erection, as well as reduced sensation or difficulty with ejaculation. Women may experience decreased sensation or heightened sensation that may be painful, as well as vaginal dryness.

Many of these symptoms can be addressed in some way.

Certain medications can be prescribed to help try to address erectile dysfunction. “Though, men may or may not have adequate response to the medication because of the neurological impact of that organ system [due to MS],” explains Sanders. Talk to your doctor about which medication might be best for you.

The National Multiple Sclerosis Society also recommends liberally applying lubricants to help with vaginal dryness, and using a vibrator to help increase stimulation and arousal.

“Each of these issues deserves attention,” adds Kyla E. Black, a licensed clinical social worker and certified sex therapist based in Westchester, New York. “My advice would be to seek support from a certified sex therapist, as well as have conversations with your preferred medical providers, to fully understand the range of options for treatment and management.”

Sanders recommends seeking out other specialists, like a gynecologist or urologist, “as they have additional expertise in managing these dysfunctions, as well.”

Plan for Other Symptoms

Other symptoms of MS can also affect a person’s ability to have sex comfortably, notes Sanders. Talk to your care team if symptoms like fatigue, bladder and bowel symptoms, spasticity, or cognitive changes seem to be interfering with sex or intimacy. Your care team may be able to recommend strategies that can help. For example:

To help with fatigue, you could schedule sexual activity for a time of day when you’re typically more energized.
In the case or bladder or bowel issues, you might plan to use the bathroom immediately before a sexual encounter and put a pad or towel down on the bed.
To help with spasticity, explore different positions to reduce discomfort.
For cognitive issues, it could help to remove unnecessary distractions from the room before sex.

Be Open with Your Partner

Talk about what is and isn’t working for you, what you enjoy, and what you don’t. “Whether you have MS, another chronic condition, or nothing at all, open and honest communication skills are paramount for every relationship,” Black says. “It’s important to be able to create a safe space with your partner to discuss sexual concerns and obstacles, express feelings and desires, and be able to explore together how to create a mutually satisfying and respectful—and fun!—erotic world.”

Get Creative to Promote Intimacy

Sex and intimacy can involve a whole range of activities. “There are many ways to be intimate with your partner that may not involve actual sexual intercourse,” Sanders says. “Find ways that fit your physical and sexual abilities … and build on those things in order to keep that level of intimacy with your partner.”

Consider trying one of these strategies:

Engaging in flirting and foreplay
Experimenting with fantasy
Bringing a new toy into the bedroom
Exploring erotic massage
Trying sensate focus, a therapy technique involving touching and being touched
Trying nondemand pleasuring activities, which involve touching each other without the expectation of sexual arousal

“These types of activities can all allow for flexibility around erotic play and pleasure,” Black says. “Focus on what feels good, learn what else might feel good, and do more of that.”

Don’t Neglect the Emotional Side

Sexual pleasure is often more than just physical. Taking steps to tackle any emotional challenges that come with MS, such as self-esteem issues or the stress of living with a chronic condition, can help you (and your partner) overcome the impact they may have in the bedroom.

“Overcoming these types of issues has to do with creating a comprehensive network of internal and external supports,” says Black, who recommends:

Establishing a solid support system that includes your partner as well as family and friends
Continuing to engage in your favorite activities and hobbies
Connecting with a support group consisting of others who have MS and understand what you’re going through
Addressing any mental health concerns with your doctor or a mental health professional
Meditating and practicing self-acceptance
Leading a healthy lifestyle, including eating a balanced diet and staying hydrated, staying as physically active as possible, and prioritizing healthy sleep habits

“All of these things affect someone’s intimate relationship and sex life,” Black says.

Seek Professional Help

If you’re experiencing persistent issues in the bedroom and aren’t satisfied with your sex life, consider reaching out to a certified sex therapist for help.

“There also doesn’t have to be a problem for an individual or couple—or any number of partners—to benefit from working with a sex therapist,” Black says. “Often, people feel strong in their relationships and are seeking to enhance and expand it and grow in all sorts of ways that a professional can support.”

Find one near you through the directory provided by the American Association of Sexuality Educators, Counselors, and Therapists.

Remember: You Can Have a Fulfilling Sex Life

The final word? “People with chronic health conditions can most certainly continue to enjoy sexual pleasure and eroticism and intimacy throughout their lives,” Black says.

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