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Highlights
- Multiple sclerosis (MS) is linked to sexual dysfunction, including erectile dysfunction (ED).
- ED in men with MS may be linked to nerve issues, physical MS symptoms, the emotional impact of MS, or medication side effects.
- Your provider will complete a comprehensive exam to help you find the best treatment options.
- Treatment for ED includes therapy, lifestyle changes, medication adjustments, and oral ED medications.
- Take advantage of eDrugstore’s resources and enjoy a healthy sex life after MS diagnosis.
Michael DiLeo, MD, has over 30 years of experience in clinical and academic medicine. Through medical school, residency, and private practice, he has functioned as both a specialist and a primary care practitioner. He has twice served as chief of staff of a large regional hospital. He is a published author on women's health for McGraw-Hill. Learn More
Multiple sclerosis (MS) and sexual health have a fraught relationship. MS is linked to sexual dysfunction — men with MS tend to struggle with erectile dysfunction (ED) and ejaculation problems, like delayed ejaculation.
But living with MS doesn’t mean the end to a fulfilling sex life. We’re covering the complex relationship between MS and ED, including how to bounce back in the bedroom.
How MS Can Lead to Erectile Dysfunction
Men living with MS are at an increased risk for experiencing ED. The exact cause of this link is unknown, but experts have identified several contributing factors. The link may be directly related to MS symptoms, the mental and emotional toll of MS, or medication side effects.
Nerve Signal Interference
MS causes lesions in the brain and spinal cord. These lesions can disrupt the nerve pathways responsible for arousal and erections. This makes it difficult for your brain and your genitals to communicate, which makes it harder for you to get and keep an erection.
Physical Symptoms of MS
The physical symptoms of MS can make it harder for you to engage in and enjoy sex. Common MS symptoms can limit your mobility, cause pain and discomfort, and contribute to a loss of interest in sex. These symptoms include:
- Muscle weakness
- Fatigue
- Tremors
- Spasticity (muscle stiffness)
MS is also linked to a number of symptoms and challenges that affect the pelvic floor, such as bladder control issues and chronic pelvic pain. These symptoms can also make it harder to get and keep an erection.
Emotional and Social Factors
Living with MS can take a heavy emotional toll, which can lead to:
- Mental health conditions. Conditions like anxiety and depression are major contributors to ED.
- Self-esteem and body image issues. Negative feelings about your body and self-worth can decrease your sexual confidence and interest in sex.
- Relationship problems. Managing a chronic illness like MS can strain relationships, leading to communication and intimacy problems.
- Chronic stress. Stress from managing a chronic illness can further worsen sexual dysfunction.
Medication Side Effects
Medications used to treat MS can cause or contribute to ED. Drugs for muscle spasticity, pain, and other MS issues often have side effects that affect sexual function. Some of these medications can make you tired, lower your sex drive, or directly affect erections.
Prevalence of ED in Men with MS
ED is much more common in men with MS than in those without the condition. Studies show that between 50 percent to 90 percent of men with MS experience ED. Other risk factors can also increase your risk for ED, including:
- Age. Your risk for ED increases as you age.
- MS symptoms. The severity of your MS symptoms can increase your risk for ED. The longer you live with MS, and the more the disease progresses, the more likely you are to experience sexual dysfunction.
- Other conditions. MS is linked to chronic conditions like diabetes and cardiovascular disease. These conditions are also linked to ED.
Diagnosis and Evaluation
Living with MS often means having more frequent healthcare visits for routine check-ups or specialized care. The silver lining of more frequent health visits is that you have more opportunities to talk to a provider about your sexual health and function.
Communicating with Your Healthcare Provider
Open communication with your healthcare provider is crucial. If you have MS and experience sexual dysfunction, don’t let embarrassment stop you from seeking help. Talking about these issues ensures they don’t go unaddressed or overlooked.
Your provider can help pinpoint the causes of ED and suggest effective treatments based on your personal health history.
Comprehensive Evaluation
Because MS and ED are both complex conditions, your provider will likely conduct a comprehensive evaluation which might include:
- Medication review. Your provider will review all the medications you are taking. Some drugs might have side effects that affect your sexual function.
- Questionnaires. One helpful tool is the Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-19). It has 19 questions about how often MS symptoms have affected your sexual function in the last six months. It only takes about two minutes to complete.
- Assessing physical MS symptoms. They will assess your MS symptoms that affect your sexual function, like muscle weakness, spasticity, and fatigue.
- Evaluating mental and emotional health. They will also assess your mental and emotional well-being, looking for mental health concerns that could contribute to ED.
Treatment Options for ED
Tackling ED in men with MS requires a well-rounded approach. Open communication with your healthcare team and personalized treatment plans can make a big difference, improving both your sexual health and overall quality of life.
Therapy and Counseling
Addressing the emotional impact and causes of ED is just as important as tackling the physical aspects of the condition. You might benefit from psychotherapy such as cognitive behavior therapy (CBT) for ED treatment. Therapy can help you to manage stress, anxiety, self-esteem, and relationship issues that often come with ED.
Some couples benefit from seeing a sex therapist or a marriage counselor so they can work together to fix intimacy issues after ED. A sex therapist can provide useful tips and techniques to improve intimacy and sexual satisfaction for the long run.
Medication Adjustments
Some of the medications used to treat MS can make ED worse. If this is the case, your doctor might adjust your medication plan to reduce these side effects. This could involve changing doses or switching to different drugs that are less likely to impact your sexual function.
Never adjust your MS medications without talking to your doctor. They can help you to find the best solution that won’t compromise your MS treatment plan.
Techniques to Improve Sensation and Mobility
Improving genital sensation and supporting mobility can make a big difference during sex for men with MS. Here are some techniques to try:
- Work with a therapist. A physical therapist or occupational therapist can offer personalized advice and techniques to improve comfort and mobility during sex.
- Use a vacuum pump. This device increases blood flow to the penis, helping you to achieve and maintain an erection.
- Explore assistive devices. Mobility aids and sexual assistive devices, like sexual support pillows, can help with positioning and comfort.
- Alternative stimulation methods. Sex therapists can suggest new ways to stimulate and increase arousal, which can be particularly helpful for men with MS who experience reduced sensation.
Lifestyle Changes for ED
Making healthy lifestyle changes can go a long way in supporting your sexual health and overall well-being. Here are some simple steps you can take:
- Exercise regularly. Regular physical activity improves blood flow and reduces stress, both of which can help with ED.
- Eat a balanced diet. Eating nutritious foods helps maintain a healthy weight and boosts overall health.
- Quit smoking. Quitting smoking can help to improve your overall health and your circulation.
- Limit alcohol. Alcohol can cause temporary ED. Long-term alcohol consumption can also contribute to overall health problems, including ED.
ED Medications for Men with MS
Oral ED medications like Viagra have shown incredible effectiveness in treating ED. Phosphodiesterase-type 5 (PDE-5) inhibitors work by increasing blood flow to the penis, making it easier for you to get and keep an erection. These drugs are the first-line defense in treating ED:
- Sildenafil (Viagra)
- Tadalafil (Cialis)
- Avanafil (Stendra)
- Vardenafil (previously sold as Levitra)
If oral ED medications don’t work for you, your provider might recommend other ED medications or more intensive therapies, such as:
- Injectable ED medications
- Suppository ED medications
- Shockwave therapy
- Surgical implants
A Healthy Sex Life After MS Diagnosis
MS doesn’t have to define your sex life. ED can be managed with lifestyle changes, medication adjustments, therapy, and oral ED medication. A healthcare provider can help you to find the best solution for your needs.
At eDrugstore, we offer a range of ED medications and support services. This includes a free consultation with a U.S.-licensed physician and free shipping on every order. Explore your options today at eDrugstore.com and take the first step towards a fulfilling, healthy sex life.
Shelby is a public health professional with research and field experience in sexual and reproductive health. She holds a Master of Public Health (MPH) and is a Certified Health Education Specialist (CHES).