Have you heard the joke about the woman who suffers from SADD -- Sexual Attention Deficit Disorder? She's so disinterested in her partner that she uses lovemaking as the perfect time to lie back and mentally reorganize the kitchen cupboards.
Perhaps you've missed that joke, but with multiple sclerosis, the inability to "stay on task" is no laughing matter. MS symptoms that interfere with attention and concentration make it difficult for some women to sustain desire during sexual intimacy.
In addition to this unique problem, consider this: a 1990 study found that...
- Fifty-six percent of the participants reported negative changes in sexual functioning after the onset of MS.
- Women who said they were less sexually active following MS reported changed sensation in the genital region, reduced vaginal lubrication, and reduced sexual desire.
- Sexual problems of a secondary nature were reportedly due to paresis, spasticity, and incontinence.
This study also found a significant relationship between sexual dysfunction and level of disability. (Stenager et al 1990)
The challenge of coping with sexual changes in MS means determining the source of the difficulty as:
- primary (direct physical): Fatigue, decreased or altered sensation, decreased libido, decreased frequency or loss of orgasm, difficulty with arousal decreased vaginal lubrication, and decreased frequency and/or intensity of orgasm
- secondary (indirect physical): Paresis, spasticity, and incontinence, cognitive drifting, incoordination, muscle weakness,
- tertiary (psychosocial) sources: Lack of a partner, decreased interest from a partner, anxiety, and loss of self-esteem
It's quite difficult for any woman to feel sexually alive when physical problems such as fatigue and altered sensations interfere with intimacy. The first line of attack against primary symptoms is generally an appointment with a healthcare professional who is knowledgeable and understanding of these concerns as they relate to MS.
Finding solutions to primary problems requires a detailed medical assessment. This assessment might include an evaluation of medications for possible side effects that interfere with sexual libido and/or sensation. Clearly, an aggressive approach to managing symptoms can improve the nature of sexual functioning. However, there may need to be some fine-tuning in cases where using a medication for one symptom causes an undesirable side effect. For example, if a medication used to manage fatigue produces decreased libido as a side effect, the physician and patient may have to adjust dosages or find another treatment that doesn't cause side effects that will exacerbate sexual dysfunction.
Open communications is key to addressing the problem of sexual dysfunction in women with MS. Communications with healthcare professionals should include the partner as well as the patient. The quality of any solution is directly linked to the ability of the partners to freely discuss these sexual issues and determine possible options that each can be excited about.
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