Like I told the women in my article on Top 10 Sex Tips for Women with MS, don't expect these ideas to lead to unprecedented sexual adventures or prowess (although you never know). These strategies may help you troubleshoot some common stressful situations and bring some more pleasure into lovemaking.
1. Talk Openly With Your PartnerReally good sex relies on open communication with your partner. As you experience different MS symptoms, things will change in many different parts of your relationship, not just around sex. You may need more help performing daily tasks or taking care of yourself than you did before. These changes will require patience, understanding and experimentation on the part of both your partner and yourself. Emotions can greatly impact sexual health. By maintaining good communication and intimacy, you and your partner will be able to adapt to changes as necessary.
2. Manage Other Health ConditionsHealth conditions that have nothing to do with MS, like high blood pressure or arthritis, can make a healthy sex life difficult. By aggressively managing any health conditions, you can greatly reduce their impact on your sex life. A good approach is to follow your doctor’s advice and make lifestyle changes.
3. Talk To Your DoctorWhen we go to the neurologist or other doctor that is helping us manage our MS, all of us (including the docs) tend to focus on neurological symptoms and signs, medication side effects and any changes in our mobility. Sexual dysfunction is a very real symptom of MS and should be mentioned to your neurologist. Your doctor cannot help you with your sexual concerns unless you mention them, as uncomfortable as this may be at first. Some sexual problems are actually medication side effects, which can be handled by adjusting medications that you are already taking or changing the time of day that you take medications. There are many medications available that also directly treat sexual problems.
4. Experiment With Positions and TimesSometimes varying your usual sexual position can relieve sexual problems, especially if they are related to other MS symptoms, such as pain, weakness or spasticity. You may also notice that your symptoms, such as fatigue, are better at a certain time of day. Try having sex when you are feeling your best, even if this does not correspond to "usual timing" of sex. You may be surprised at the difference this makes.
5. Expand Your Concept of SexMen tend to think of sex in terms of orgasms, but there can be a lot more to sex. As you live with MS, you may need more time and physical contact to become aroused. You may also find it harder to concentrate on the moment if you experience cognitive difficulties. Hugging, kissing and other forms of contact are essential parts of your sex life. Masturbation is part of a normal, healthy sex life, as well.
6. Avoid Alcohol and SmokingBoth alcohol and smoking can hinder a man’s ability to achieve an erection. These two substances alter the blood flow in your body and can limit the amount of blood that enters the penis. This can lead to the inability to have an erection, difficulty maintaining an erection or an erection that is softer than normal. If this is happening, consider abstaining from smoking and alcohol.
7. Expect DifficultiesAs time goes by, you will experience certain changes in your sexual function, whether these changes are caused by MS or not. When these changes occur, don’t panic. If you react emotionally to these problems, you can make them worse. By expecting some degree of sexual change as you age, you can react calmly and troubleshoot your situation.
8. Eat Healthy and Lose WeightBeing overweight puts a strain on your body that can result in high blood pressure, heart disease, diabetes and other health conditions, all of which can interfere with a normal sex life. Eating healthy foods and losing excess weight will help you feel better all around, and may lessen the impact of other MS symptoms, not just sexual dysfunction.
9. Stay Sexually ActiveIf you have a long period of time in your life when you are sexually inactive, it will be more difficult to become sexually active later. Not only can frequent sex improve your sexual performance, it can actually even help you live longer, help you feel better about yourself and work to fight depression and stress. Just make sure to practice safe sex (if you are not in a long-term committed relationship).
10. Time Your MedicationsCertain medications can impair (or help) sexual functioning. For instance:
- If you take anticholinergics for bladder dysfunction, taking these 30 minutes before sex can minimize bladder contractions during sex. These include: Propantheline (Norpanth, Pro-Banthine), Tolterodine (Detrol tablets and Detrol LA extended-release capsules), Dicyclomine (Bentyl).
- Medications for fatigue taken one hour before sex can put you at your peak energy level. These include Provigil and Symmetrel.
- If you take antidepressants, these may be having a negative effect on your sex drive. Talk to your doctor if you think this might be the case, because certain antidepressants may have less sexual side effects than others.
- If you self-inject (or have your partner inject you with) one of the disease-modifying medications, coordinate the timing of your injection with any possible sexual activity. Injections may cause so much stress or unpleasant side effects that sex right after a shot is completely out of the question. On the other hand, some men may get such a rush of relief after an injection that it puts them in the mood.
Nancy J. Holland and June Halper. Multiple Sclerosis: A Self-Care Guide to Wellness. New York: Demos Publishing. 2005.
Allison Shadday. MS and Your Feelings. Alameda: Hunter House Publishers, 2007.