Sexual problems affecting men
Sexual arousal, response and orgasm rely on messages being sent between the brain and sexual organs, through the spinal cord.
If you have MS related nerve damage in the parts of your brain and spinal cord that are involved, you might have problems with erections and ejaculation.
There can be other causes of erectile dysfunction too, like the side effects of medication, psychological factors or an unrelated health condition. By talking to your doctor or MS nurse about it, you can find out what’s causing it and get these other causes treated.
Erectile problems
Around 70 per cent of men with MS experience erectile problems. They generally start some years after the first symptoms of MS appear. Sometimes MS isn't directly to blame, it can be side effects of medication or an unrelated health condition.
Depending on where your nerve damage is, you might find you can get an erection in response to genital stimulation, but not in response to anything else. Sometimes it's the other way round.
Drug treatments
There are drug treatments which can work for some men, including Viagra (drug name sildenafil citrate),Levitra (vardenafil) and Cialis (tadalafil). All these drugs work in a similar way, but vary in how quickly they take effect and how long they remain active.
The drugs work by enhancing blood flow into the penis, and increasing any erectile response that occurs – either through genital stimulation, or erotic thoughts and situations. Viagra takes between 30 minutes and two hours to take effect and lasts for up to four hours.
Not all men find pills effective in treating erectile dysfunction.
Some of these drugs are for sale on the internet. But they might not be suitable for everyone, so it’s important they're prescribed by your doctor, who knows your medical history and other medicines you take (and any possible interactions). They can discuss any potential side effects with you.
Read NHS advice about precautions to take if you buy prescribed Viagra online
There are other treatments available:
Prostaglandins are a hormone-like substance naturally produced in the body. You can try synthetic versions of prostaglandins to treat erectile dysfunction. They work by enhancing blood flow into the penis, to help it become rigid and erect.
Vacuum devices work by fitting a plastic tube over the penis and use a hand pump to create vacuum pressure that results in blood flow into the penis. A ring is then placed around the base of the penis to maintain the erection.
Ejaculation and orgasm
Although the treatments described above can help with erectile dysfunction, there are no treatments yet that really help with ejaculation. Ejaculation and orgasm are much more complicated processes than genital arousal, and are very hard to achieve without intact connections between the spinal cord and brain.
Between 35 and 50 per cent of men with MS experience problems with ejaculation. Problems can include delayed ejaculation or not being able to ejaculate at all. Being able to maintain an erection for longer can help, but ejaculation may remain a problem.
Although MS does not affect fertility itself, unsurprisingly if you can't ejaculate you might have a problem trying to father a child. If this is the case, a fertility clinic should be able to help. Ask for a referral from your GP or specialist.
