How to Have a Healthy Sex Life When You Have Multiple Sclerosis

How to Have a Healthy Sex Life When You Have Multiple Sclerosis
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Updated on February 19, 2025
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Multiple sclerosis (MS) is a chronic disease that affects your central nervous system: your brain, spinal cord, and optic nerves. It can also affect your sexual function and desire.

Research shows that 50 to 90 percent of men and 40 to 80 percent of women with MS experience some kind of sexual dysfunction.

Those statistics may seem daunting, but once you understand how MS leads to challenges with sex, you can focus on regaining your enjoyment of sexual intimacy.

How MS Impacts Sexual Function

Sexual arousal begins in the central nervous system, with the brain transmitting signals to the sexual organs via nerves in the spinal cord. If the brain lesions that are characteristic of MS interfere with the connection between the brain and the sexual organs, it can result in sexual dysfunction.

Psychological issues that often accompany MS — such as depression, stress, and problems with body image — can also impact your sex life.

Physiological Effects of MS on Sexuality

MS can directly affect your sexual response and function if it damages the nerves that carry messages from your brain to your sexual organs, says Nicholas G. LaRocca, PhD, a clinical psychologist who specializes in MS and is a consultant for the National Multiple Sclerosis Society (NMSS).

Other MS symptoms, such as fatigue, spasticity, and abnormal sensations, can also dampen desire.

For men, the sexual side effects of MS can include:

In women, sexual challenges in MS may involve:

Both men and women may have trouble becoming aroused and reaching orgasm.

Indirect Effects of MS on Sexuality

Common psychological symptoms of MS, including stress, anxiety, and depression, can impact your libido.

 You may also feel self-conscious if your body looks or feels different.

“Many individuals with MS no longer see themselves as sexually desirable, and this negatively impacts their sex lives,” says Donna Graves, MD, the specialty medical director of neurology at Atrium Health Neurosciences Institute in Charlotte, North Carolina.

Some MS symptoms may be so personal or embarrassing that you have a difficult time telling your partner about them and decide to avoid sex altogether. “Bladder and bowel control problems can present some fairly significant challenges,” Dr. LaRocca says. “Those kinds of symptoms are not directly related to sexual machinery, but can interfere with interest and ability to participate in sex. One of the biggest losses is that loss of spontaneity.”

How MS Affects Sexual Desire in Women

Women with MS may have some unique challenges with reduced sex drive. Research suggests these factors play a large part in female libido:

  • Interpersonal conflict
  • Poor communication with their partner
  • Self-image
When women feel chronic pain, fatigue, and stress with MS, it can affect their sex drive more than it does in men with the same diagnosis.

Why Do So Many People With MS Experience Fatigue?

The reasons behind MS fatigue aren’t fully understood, but neurologist Mill Etienne, MD, MPH, explains what could be contributing to it.
Why Do So Many People With MS Experience Fatigue?

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Medical Treatments to Improve Sexual Function With MS

Your healthcare provider can advise you on medical treatments that may improve sexual function and desire with MS. “Sexual health is an essential yet often under-discussed component of overall well-being for individuals with MS,” says Achilles Ntranos, MD, an MS neurologist in Los Angeles.

A good starting point is to address MS symptoms, he adds. “Optimizing a patient’s MS therapies — like adjusting disease-modifying treatments, fine-tuning spasticity medications … and managing neuropathic pain — can often improve comfort and sexual satisfaction.”

Here are some recommended treatments.

Medications for Erectile Dysfunction Medications for erectile dysfunction include sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). “These medications help increase blood flow and can be very effective,” says Dr. Ntranos.

Penile Implants Men who experience erectile dysfunction can also choose to use penile implants to assist with erections. Options include an inflatable penile prosthesis and a semi-rigid prosthesis, both surgically implanted.

Testosterone Men can take testosterone as a cream, gel, skin patch, or injection.

 “Hormone replacement (under careful supervision) may improve sexual desire and energy levels,” says Ntranos.
Estrogen Some medications for hormone replacement in women increase estrogen or mimic its effects. These include oral medication and creams, rings, or tablet inserted into the vagina.

Antispasticity Medication Taken 30 minutes before sexual activity, some medications can lessen spasms during the encounter. These include baclofen (Lioresal, Lyflex), tizanidine (Zanaflex), gabapentin (Neurontin), and diazepam (Valium).

Intermittent Catheterization Emptying the bladder with an intermittent catheter (which you only use when needed) before sex can help control urinary leakage during intercourse.

Pelvic Floor Exercises A physical therapist can teach you how to strengthen the muscles in your pelvis, which play a big role in sex.

Other Ways to Regain Your Enjoyment of Sex

In addition to medical treatments, there are other ways to experience pleasure and intimacy.

“Sex often needs to be a planned event for individuals with MS, so plan a time with no distractions, and coordinate your medications to optimize your control of any symptoms that may interfere with sex,” says Dr. Graves.

Other things you can try include:

Vaginal Lubricants and Moisturizers For vaginal dryness, you can apply moisturizers every few days, or lubricants just before a sexual encounter.

Vibrators Couples may consider using a vibrator to boost stimulation, arousal, and pleasure.

Penile or Clitoral Pumps These devices can help stimulate sexual organs manually.

Therapy For partners with sexual challenges, it may help to work with a mental health professional or sex therapist. These providers can offer cognitive behavioral therapy (CBT), individual counseling, or couples therapy.

“Working with a counselor specialized in sexual health allows partners to learn coping strategies, set realistic expectations, and maintain emotional closeness,” says Ntranos.

Open Communication Although it can feel embarrassing or difficult to talk about sex, communication is the first step to getting your sex life back on course.

 “[It’s key to] encourage patients and their partners to discuss what feels good, what doesn’t, and any concerns about fatigue or pain,” says Ntranos.
Mindfulness Mindfulness practices may help lessen erectile dysfunction and sexual distress. Meditation, deep breathing, and body scanning can improve sexual desire, satisfaction, and function.

 “[These] exercises can improve focus on pleasurable sensations during intimacy and reduce stress or performance anxiety. Simple guided meditations or breathing exercises pre-intimacy can set a calmer tone,” says Ntranos.

Talk with your doctor about what treatment or combination of treatments would be most helpful for you. Sexual dysfunction is quite common, so chances are, your doctor is more comfortable with the topic than you think, Graves says. They may also refer you to other experts such as a urologist or therapist.

The Takeaway

  • The brain lesions caused by MS are believed to cause sexual dysfunction.
  • Multiple sclerosis can cause symptoms like pain, fatigue, and spasms, which can decrease libido and lessen sensations, but various treatments and strategies can help people with MS have a fulfilling sex life.
  • Medical treatments for MS include medications, intermittent catheterization, and surgical implants.
  • Other tools for a sex-life boost include lubricants, moisturizers, and pumps, as well as using mindfulness, open communication, and speaking with a mental health professional alone or with a partner.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Altmann P et al. Predisposing Factors for Sexual Dysfunction in Multiple Sclerosis. Frontiers in Neurology. February 9, 2021.
  2. Sexual Dysfunction. National Multiple Sclerosis Society.
  3. Ramezani M et al. The Impact of Brain Lesions on Sexual Dysfunction in Patients With Multiple Sclerosis: A Systematic Review of Magnetic Resonance Imaging Studies. Multiple Sclerosis and Related Disorders. January 2022.
  4. Hendin B. Sexual Dysfunction . Multiple Sclerosis Association of America. January 2024.
  5. Friedmann E et al. Women and Men’s Perspectives on the Factors Related to Women’s Dyadic Sexual Desire, and on the Treatment of Hypoactive Sexual Desire Disorder. Journal of Clinical Medicine. November 15, 2021.
  6. Harris EA et al. Does Sexual Desire Fluctuate More Among Women Than Men? Archives of Sexual Behavior. January 25, 2023.
  7. Erectile Dysfunction. Johns Hopkins University.
  8. Vaginal Dryness. Cleveland Clinic. July 26, 2022.
  9. Treating Spasms and Stiffness . Multiple Sclerosis Society.
  10. Catheters. Multiple Sclerosis Trust. December 1, 2023.
  11. Hendin B. Sexual Dysfunction. Multiple Sclerosis Association of America. January 2024.
  12. Mestre-Bach G et al. Behavioral Therapies for Treating Female Sexual Dysfunctions: A State-of-the-Art Review. Journal of Clinical Medicine. May 16, 2022.
  13. Bafrani MA et al. The Effect of Psychological Interventions on Sexual and Marital Satisfaction: A Systematic Review and Meta-Analysis. Iranian Journal of Public Health. January 2023.
  14. Selice L et al. Mindfulness and Sexual Dysfunction: A Systematic Research Synthesis. Journal of Sex & Marital Therapy. October 25, 2021.
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Jason Paul Chua, MD, PhD

Medical Reviewer
Jason Chua, MD, PhD, is an assistant professor in the Department of Neurology and Division of Movement Disorders at Johns Hopkins School of Medicine. He received his training at the University of Michigan, where he obtained medical and graduate degrees, then completed a residency in neurology and a combined clinical/research fellowship in movement disorders and neurodegeneration.

Dr. Chua’s primary research interests are in neurodegenerative disease, with a special focus on the cellular housekeeping pathway of autophagy and its impact on disease development in diseases such as Parkinson disease. His work has been supported by multiple research training and career development grants from the National Institute of Neurological Disorders and Stroke and the American Academy of Neurology. He is the primary or coauthor of 14 peer-reviewed scientific publications and two peer-reviewed online learning modules from the American Academy of Neurology. He is also a contributing author to The Little Black Book of Neurology by Osama Zaldat, MD and Alan Lerner, MD, and has peer reviewed for the scientific journals Autophagy, eLife, and Neurobiology of Disease.
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Madeline Vann, MPH, LPC, is a freelance health and medical writer located in Williamsburg, Virginia. She has been writing for over 15 years and can present complicated health topics at any reading level. Her writing has appeared in HealthDay, the Huffington Post, Costco Connection, the New Orleans Times-Picayune, the Huntsville Times, and numerous academic publications.

She received her bachelor's degree from Trinity University, and has a master of public health degree from Tulane University. Her areas of interest include diet, fitness, chronic and infectious diseases, oral health, biotechnology, cancer, positive psychology, caregiving, end-of-life issues, and the intersection between environmental health and individual health.

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