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MS: How to Talk With Your Doctor About Sex

Sexual dysfunction is a common symptom of MS. Here's how to talk to your doctor to address — and remedy — these concerns.

Talking about sex can be difficult, and talking about sex with your MS doctor is no exception. But with more than half of people who have MS reporting difficulties with sexual function, now is a good time to start having those conversations.

“If I had my druthers, doctors would ask about this from the beginning, but unfortunately, they don't,” says Rosalind Kalb, PhD, the vice president of the professional resource center at the National Multiple Sclerosis Society and the lead author of Multiple Sclerosis for Dummies.

Carrie Lyn Sammarco, a nurse practitioner at the NYU Langone Multiple Sclerosis Comprehensive Care Center in New York City, agrees that awkward or not, the subject of sex needs to be on the table during doctor visits, particularly since “a healthy sex life will have important spillover effects on overall quality of life.”

But how do you know if your sexual problems are related to multiple sclerosis?

Sexual Symptoms Vary

MS doesn't play by a rule book, Kalb says, and symptoms of MS, including sexual symptoms, vary from person to person.

"Some people might experience changes in how aroused they get and in their ability to have an orgasm," Kalb says. "All kinds of things can change or happen in your body with MS, and things that used to feel good don't feel like anything at all or feel bad.”

Numbness, which is common in the hands and feet in people with MS, may occur in the genital area, too.

For men who have MS, symptoms may include being unable to achieve or maintain an erection. For women, they may include a decrease in libido, reduced or painful sensations in the genitals, or vaginal dryness.

Sexual issues can also be related to symptoms such as fatigue, stiffness, or depression, or they can be side effects of MS medications, says Sammarco.

According to Kalb, “People with MS are sometimes relieved to know that a symptom may be related to the disease, and that can make it easier to bring up.”

How to Start the Sex Conversation

If you feel uncomfortable discussing sex with your doctor, plan how you’ll bring it up before your appointment. You might try mentioning that you read that MS can affect a person’s sex life and ask your doctor how, when, and why this can occur.

“The doctor’s next question should be, ‘Are you having a problem in this area?'" Kalb says.

You could also say something like, "I've noticed some changes in my sex life" (or sexual responses, or whatever words you are most comfortable with), "and I am wondering if they could be related to MS or any medications I’m taking," Kalb suggests.

This should lead your doctor to respond with, "Tell me more about the changes," Kalb says.

You don’t have to have this conversation with your neurologist, necessarily.

"It can be with your obstetrician-gynecologist or whatever doctor you feel most comfortable with," Kalb says. You may find it easier to speak with a nurse in your doctor's office or with your primary care physician, who may have more experience addressing their patients’ sexual health concerns.

"If a person is being treated in an MS center, sex is more likely to come up during routine visits," she adds. Care offered at an MS center takes into account every aspect of a person's life and well-being.

Kalb encourages all people with MS to read about how the disease can affect sexual functioning so they are not embarrassed to discuss it with their doctor or partner.

“It's another symptom, and it is important to bring it up, because there are strategies to make it better," she stresses.

Troubleshooting Sexual Problems

Not all sexual issues require medical intervention. Some you can solve for yourself. For instance, if you're too tired for sex at night, schedule it for the morning or afternoon.

Education and counseling have also been shown to help some couples and individuals affected by MS improve their sexual satisfaction. A randomized study involving 62 women from an MS clinic in Edmonton, Alberta, for example, found that access to written materials on sexual dysfunction, with or without three counseling sessions with an MS nurse, reduced symptoms among study participants and helped the women communicate with their spouses about sexual concerns.

If a medical condition is negatively affecting your sex life, let your doctor know. Many complications of MS, such as urinary urgency, will respond to targeted treatment, Kalb says. If you're a man with trouble achieving or sustaining an erection, a drug for erectile dysfunction may help.

But regardless of the cause of your sexual problems, if you’d like more guidance on sexual matters, consider seeing a sex therapist. A therapist can help to build communication and intimacy between partners, even when there is a medical reason for sexual dysfunction.

By Denise Mann
Medically Reviewed by Justin Laube, MD

Story Source: The above story is based on materials provided by EVERYDAYHEALTH
Note: Materials may be edited for content and length


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