Multiple Sclerosis: Talking with Your Doctor about Sex

Talking about sex can be difficult, and talking about sex with your multiple sclerosis (MS) to your doctor is no exception. While it is perfectly understandable that you may feel embarrassed discussing the subject, doing so can actually improve your sex life. With more than half of individuals who have MS reporting difficulties with sexual function, now is a good time to start having these conversations.

A great way to bring up the subject to your doctor is by discussing it in a very general way in the beginning. Start off by saying something such as “I’ve heard that a lot of individuals with MS experience issues with sexual dysfunction, is that true?” Your doctor may then become curious and ask if you are experiencing such issues. Keep in mind that you do not have to go into extreme detail in discussing your sex life. You can respond by simply mentioning that you have been noticing a few changes lately and you are not sure how to address them. This should lead your doctor to respond with, “Tell me more about the changes”.

As you are well aware, MS doesn’t play by a rule book. Every individual has different symptoms of MS, including sexual symptoms. Sexual arousal begins in the central nervous system. The brain sends signals to the sexual organs along nerves that run through the spinal cord. If MS damages these nerve pathways, sexual response can be directly affected. For men who have MS, symptoms may include being unable to achieve or maintain an erection. For women, they may include reduced sensations in the genitals, a decrease in libido, or vaginal dryness. Numbness, which is common in the hands and feet in individuals with MS, may even occur in the genital area. Such changes in sexual function can either be a direct result of neurologic changes, psychosocial problems; symptomatic problems (spasticity or bladder problems) or they can be side effects of particular medications.

Many of you may even feel relieved to know when a symptom may be related to a disease because it makes it easier to bring up. Even though it is just another symptom, there are approaches to make it better. In fact, many problems associated with neurologic changes or symptomatic problems of MS can be medically managed. While medical appointments might seem invasive and awkward at times, the relationship you build with your doctor will eventually impact upon your health and overall well-being. Just like any good working relationship, this requires open communication and truthfulness – including the good, the bad, and the ugly.

Tell the truth about any physical changes

There is a reason why your doctor always asks “how are you?” They are genuinely interested in your health and the most important information comes from you. Their job is to examine you – the frustrating bladder issues that have been keeping you up at night, the difficulty you have had concentrating, the odd sensation that you have been feeling in your hand - all of these symptoms may be significant and may alter the management of your treatment. Even the slightest change could make a difference to your symptoms. Don’t be too proud to share or ignore the problem – this won’t make it go away on its own. Consider keeping a journal and jotting down any physical changes. During your check-up, hand it to your doctor if that makes it easier for you. When words fail, feelings take over.

Express your feelings

Your psychological and emotional well-being are just as important as your physical well-being. If you are feeling stressed, depressed or even anxious (all common symptoms in MS), let your doctor know. Dealing with a chronic condition is never easy, but there is no need to suffer in silence. Be open about your symptoms and feelings and seek medical advice in return.

Admit to your bad habits

We all have bad habits – even doctors. Your doctor is not there to judge, but rather to help you manage your condition in the best possible way for you. This means full disclosure about how much you really smoke, drink, eat, and exercise. If you are drinking heavily or you are considering quitting smoking, be honest and forthright with your doctor. You won’t get a lecture, but perhaps you may get a simple nudge in the right direction.

Be honest about your energy levels

Up to 90% of individuals with MS experience tiredness - it is one of the most common symptoms of MS. If it is significantly affecting you, let your physician know. Rather than simply dismissing the symptom, have your doctor explore the underlying causes (bladder issues, sleep apnea, etc.). It may affect your treatment and have an impact on your mental health and mobility.

Just because you have MS, it doesn’t mean that your sexual desires will go away or become inappropriate. Giving up sexual activity is not a solution to this. In fact, keeping up a good sex life can help your overall well-being. Confide in your partner about how MS is affecting your sex life. It may go a long way towards resolving any fears, reducing discomfort for both of you, and you may be surprised at what you learn. Your partner may even be blaming themselves without you realizing it. Talk openly can help you get started on finding creative ways to overcome the barriers together. It can also bring you closer together. Intimacy and sexuality are important components of a healthy and content life. They do not have to disappear from your lives if one of you has MS. With good communication, your symptoms won’t destroy a rewarding sex life; however, hiding the problem and anxieties associated with it might.
Whether or not you are in a relationship, difficulty in satisfying your sexual needs can cause a feeling of disappointment, frustration, and distress. The most powerful starting point for managing sexual problems is to be willing to talk about them. This may be your partner, a friend, or even a health care professional such as your GP or MS nurse. If you want to slowly break out of your shell, you can even consider discussing your concerns anonymously via a helpline or on an online forum.

Let’s face it – all symptoms of multiple sclerosis are not created equal. Some can be frightening and some, such as bladder leakage, can be just downright embarrassing. Many symptoms of MS can be managed, but that means that you have to be comfortable talking about them. So how do you proudly own up to them? Remember that you are not alone.

• 91% of men and 72% of women with MS reported they may be affected by sexual problems
• 80% of individuals with MS experience bladder dysfunction
• 68% of individuals with MS experience bowel dysfunction

Medical school prepares doctors for dealing with all aspects of the human body. If you have symptoms that are interfering with your sexual function, express your concerns to your doctor and get the help you deserve. Do you think he or she is passing judgment on you anyway?

At the end of the day, your doctor is there to help you. They can’t help you unless you are honest and comfortable in your surroundings. It is important not to hold back and inform them what’s going on in your life. The more information you can offer, the better off you will be. When it comes to maintaining a healthy sex life, honesty really is the best policy.