Let’s Talk About Sex

When I was about to start writing MS Monday, and first asked people what they wanted to hear about, sexual dysfunction and sexual problems was at the top of the list. This seemed to be a topic that was extremely prevalent, but something that not many people discussed (I sense a trend here). This was also one of the main reasons why I wanted to start writing MS Monday. To start talking about all of these things that we all experience, but seem a little hesitant to bring into every day conversation. I’ve already covered peeing yourself in public, so let’s move on!

Sexual problems are extremely common in the MS population for several reasons. The overall burden of having the disease can put a strain on relationships, which can impact communication, sexual desire and/or intimacy. MS can also directly impact the ability of your body to function correctly in terms of sexual responses, arousal or orgasm. Physical and emotional changes can also have an impact, such as fatigue, specificity, or self esteem and mood changes.

Living with MS or having a partner that has MS can be very difficult at times. There’s a lot of stress and uncertainty that surrounds this disease, and even couples that are seasoned at handling stressful times can find themselves impacted at one time or another. If a couple is lacking positive communication in general, this can easily lead to a breakdown in intimacy as well. For this disease (and any other issue really) Communication is key. The ability to be open with your partner is huge when trying to manage MS and all of the symptoms that go along with it.

From a biological standpoint, MS can mess things up for both men and women due to The fact that sexual arousal, response and orgasm needs a clear pathway from the brain through the spinal cord, which often isn’t present as disease progresses. In men, erectile dysfunction and issues with ejaculation and reaching orgasm can be present.  In women, reduced sensations in vaginal/clitoral areas, increased pain, issues with vaginal lubrication and difficulty reaching orgasm can be present.

Other physical side effects can also have a impact on sexual function. Fatigue, spasticity, mood changes, bladder or bowel control, etc. all of these other symptoms can have a an effect on sexual comfort or performance. This is another example of one communication with your partner is key. Being able to say that “yes, you would like to be intimate with them but this other symptom is standing in the way”, is so important. it is important for you to be able to advocate for yourself so you get your needs met, but is also important for your partner to hear that MS is standing in the way, not that they have done something wrong.

The treatment for sexual problems can vary. I’ve already discussed communication several times, but it definitely bears repeating. Communication with your partner is possibly the number one thing you can do to change your outlook towards sex. MS can make sex an extremely frustrating experience, but with communication, you both can tackle the issue together, instead of having it create an issue between you both.

For men, there are treatments for erectile dysfunction available, the same medications that are available for men without MS. Unfortunately there are no medications available to help with ejaculation. The process of ejaculation and orgasm are much more complicated of a process, and need intact communication between the brain and spinal cord for those processes to occur.

For women, making time for extra foreplay at the beginning of sex is incredibly useful. This can be helpful for increasing your own vaginal lubricant and also helping you get closer to orgasm from the beginning. When your own body falls a bit short, using lubricant during sex is important, as not being adequately lubricated can lead to increased pain. It is possible to still reach orgasm, but it just might take a little, lot longer than it did previously. Finding new ways to be stimulated and aroused can be very helpful in the orgasm endeavor.

One of the best things to try as a couple are exploring each other in a non-sexual way, laying with each other or massage. Being able to be physically close with your partner in a non sexual way is important, to both the health of the relationship and the sexual health of the relationship. Realizing that intimacy isn’t just about sex, but it is about being close and comfortable, was a game changer.

Being able to say, “let’s try again next time” is also important. I’ve had many situations where no matter what I tried, nothing was happening, and I just needed to be able to say, not today. Neither I, nor my husband did anything wrong, it just wasn’t in the cards for me in that day, which isn’t my fault. That is the biggest take away I hope that anyone can glean, that this isn’t your fault.

One of the aspects of sex that isn’t discussed often is the feeling of guilt that can accompany the MSer. Guilt about not “giving” enough sex, or leaving your partner high and dry. Guilt about not feeling up to it yet again, or guilt about having it hurt and having to stop. I know that I have felt these things, and more than likely, I’m probably not alone. Guilt can be a tough emotion, especially in the context of sex. It can really muddy the waters, and bring uncomfortable and yucky emotions into play. I’ve done a lot of work within myself and with my husband around these feelings. The number one thing that helped me was talking to my husband about them, and how I felt. Only when I, and him, were honest about our feelings, were we able to fully understand the impact of my guilt on our relationship.

Again, I tell you, it’s not your fault.

 

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