Managing sexual problems

Communicating is vital, and getting professional help can make a real difference.

Remember that everyone’s different. It’s a myth is that the aim of sex is intercourse and orgasm. There are many other types of sexual activity and lots of other ways of physically showing love, desire and affection.

Tips on managing sexual difficulties

• Communicate – it’s essential to understanding how MS is affecting both of you. When discussing your relationship with your partner, it generally works better if you can avoid accusing, criticising or blaming. Sentences that start with 'I feel...' and 'I would like...' may be more constructive than those that begin 'You don't...'.

• Write down how you feel - sometimes it’s hard to say things out loud.

• Try body mapping (a simple self-exploration technique in which you set aside time and gently touch all parts of the body to identify what results in sensual pleasure, discomfort or sensory change).

• Masturbation can help you discover what works for you.

• Using sex toys – find out what works for you by experimentation.

• Feeling sexy often relates to looking after yourself and taking care of your body – having a good diet, doing some exercise, enjoying relaxing activities and spending time on your physical appearance. Even simple things, like a new hair cut, can help.

• Educate yourself. There are lots of myths and misconceptions about sexuality, sexual difficulties and disability. Learning more about how MS symptoms can affect relationships and sexual function can often make it easier to understand how you feel and help you discuss problems – if you want to – with your partner.

• Massage and physical contact – creating a sense of intimacy and physical closeness is important in a relationship, particularly if penetrative sex is no longer possible for you. If you’ve stopped having physical contact, you could start slowly, by holding hands or hugging, perhaps moving on to light massage if you feel comfortable with it.

• Changing roles – if your partner is also your main care provider, it can be difficult to switch between the roles of carer or cared for, and lover. Completely separating caring activities from sexual or romantic activities can help. Getting some external support with caring tasks, particularly those of a highly personal nature, can also help.

For more detailed information on managing the impact MS has on relationships and sex, see our see our booklet Sex, intimacy and relationships.

Minimising other MS symptoms

Pain and spasticity

You might find that certain positions are more comfortable than others, and massage can relax the muscles and also help to create intimacy and closeness.

Find out more about pain and spasticity.

Fatigue

There may be a time of day when your energy levels are higher – such as the morning – when you might prefer to have sex. 

Planning to rest before and after sex might help too. Why not experiment with alternative positions that are less tiring and require less muscle strain?

Read about about fatigue.

Bladder and bowel problems

There are ways of managing these symptoms, particularly with the help of urologists and continence nurses.

Find out more about problems with the bladder and bowel.

Changes in mood, memory and depression

If someone is feeling depressed, they may lose interest in sex or they may ‘close off’ from other people around them. These emotional changes can be a reaction to the condition and a symptom of MS

It’s important that these emotional symptoms, like physical symptoms, are properly recognised and treated. If it’s affecting your sex life and your relationship, it can help to talk through your feelings with your partner. This may also bring you closer together – which might help with intimacy.

Find out more about emotional issues and memory problems.

Side effects of medication

Changes in desire, performance and satisfaction can be a side effect of certain medications, such as some antidepressants. If you think any of your medications might be affecting you sexually, speak to your doctor or MS nurse about how you can manage this.

Some people who inject disease modifying drugs may find the injection sites tender and sensitive to touch. If this is the case, you can ask your partner to avoid those places. You can also ask your MS nurse or the drug manufacturers about injection technique, to help minimise these problems. 

Getting professional help

It can be hard, and a bit strange, to talk to health care professionals about sexual issues. It’s perfectly normal to feel shy or embarrassed. But it’s worth trying to talk to them so that they can help you find a solution to any problems.

Most health care professionals should be comfortable discussing how to deal with and treat these sensitive and intimate issues. However, it might be up to you to take the plunge, as some health care professionals can be reluctant to bring up the topic of sexual difficulties with you – they might feel it’s intrusive, insensitive, or even inappropriate. They are likely to be full of information once the subject has been broached, though.

There are no ‘rules’ over whose job it is to talk about sexual problems, so you can talk to whoever you feel most comfortable with. If it’s hard to talk to a particular professional you can ask to be referred to someone else.

You might find it helpful to write down the particular issues you’ve been having, or any questions you want to ask. That way, if you do get nervous or flustered at an appointment, you don’t forget what you wanted to say. You can also ask if there any leaflets or other printed materials you can take away with you, so that you don’t have to try to remember everything they are telling you. You could bring the MS Society’s booklet Sex, intimacy and relationships along with you and use it to start the conversation.