Medically reviewed by Mary Lucas, RN
Written by Our Editorial Team
Last updated 5/22/2022
Multiple sclerosis (MS) is a central nervous system disease that damages your brain and spinal cord. It affects an estimated 2.8 million people worldwide.
MS can cause a range of symptoms, including sexual dysfunction. If you have MS, you may find it more difficult to get an erection, reach orgasm and ejaculate during sexual contact, or just feel less interested in having sex.
Sexual dysfunction due to MS can potentially have a major impact on your wellbeing, self-esteem and quality of life. However, in many cases, sexual function issues caused by multiple sclerosis are treatable.
Below, we’ve talked about what multiple sclerosis is, as well as the link between MS and sexual dysfunction.
We’ve also explained the treatments that are available for erectile dysfunction (ED), ejaculatory dysfunction, low sexual desire and other common sex-related symptoms of MS.
Multiple sclerosis is a disease that affects your central nervous system. It damages the myelin sheath — a protective sleeve of fatty tissue that’s found on neurons or cells involved in sending chemical messages around your body.
Researchers aren’t aware of exactly what causes multiple sclerosis to develop, but many believe it could be an autoimmune disease, meaning a condition in which the immune system targets healthy cells and prevents them from functioning properly.
This damage to your nerve cells and reduced function can reduce communication between your brain and other parts of your body.
Multiple sclerosis can cause a range of symptoms, most of which first appear between the ages of 20 and forty. If you have MS, you may experience:
Vision issues, including red-color distortion, blurred/double vision or blindness
Difficulty with coordinating movement and/or staying balanced
Muscle weakness in the extremities, such as the hands and feet
Difficulty standing, walking or completing other movements
“Pins and needles,” numbness, prickling and other sensations
Tremors, dizziness, speech difficulties and other issues
Changes in mood and mental disorders, such as depression
Multiple sclerosis can also cause changes in cognitive function, such as difficulty remembering information, staying focused or making decisions. These symptoms are usually mild and affect approximately half of all people with MS.
Your central nervous system plays a critical role in sexual arousal and function. When you feel sexually aroused, impulses from nerves in your penis and brain are responsible for stimulating blood flow, allowing you to get and maintain an erection.
Because multiple sclerosis affects the function of your central nervous system, it may cause a range of problems related to your sexual response cycle.
In men, the most common sexual functioning issues associated with MS are:
Erectile dysfunction. Because of its effects on nerve function, multiple sclerosis can make it harder to get and maintain an erection. Research suggests that approximately 50 to 75 percent of men with multiple sclerosis are affected by some degree of ED.
Difficulty reaching orgasm and ejaculating. Many men with multiple sclerosis suffer from orgasmic dysfunction, or difficulty reaching orgasm and ejaculating during sexual activity.
Approximately 37 percent of men with MS report experiencing anorgasmia, or difficulty reaching orgasm even with significant sexual stimulation.
Reduced sex drive. Multiple sclerosis often goes hand in hand with a reduced level of interest in sex. Research suggests that 39 percent of men with MS report that they feel less interested in sexual activity due to their disease.
Multiple sclerosis can also cause sexual difficulties in women, including reduced libido, difficulty reaching orgasm and vaginal dryness.
In addition to affecting your sexual performance, MS can cause other symptoms that affect your genitals and urinary system. For example, due to its effects on your central nervous system, it’s common for multiple sclerosis to cause bladder dysfunction and urinary leakage.
These symptoms can have a significant impact on both your sex life and your general quality of life, especially when they prevent you from engaging in sexual activity of developing meaningful relationships.
If you have multiple sclerosis and experience symptoms that interfere with your ability to have satisfying, pleasurable sex, it’s important to talk to your healthcare provider.
Most sexual dysfunction symptoms of MS can be treated, either through medication, therapy or a combination of approaches.
If you have erectile dysfunction due to multiple sclerosis, your healthcare provider may suggest using a type of medication called a PDE5 inhibitor. This type of medication works by improving blood flow to your penis and making it easier for you to get and maintain an erection.
Common PDE5 inhibitors include sildenafil (the active ingredient in Viagra®), tadalafil (Cialis®), vardenafil (Levitra®) and avanafil (Stendra®). These medications can be taken prior to sex and typically start working within 30 minutes to one hour.
If oral medication by itself isn’t effective at treating erectile dysfunction caused by MS, you may need to use additional medication or a medical device to produce an erection. Studies suggest that the following options may be effective in combination with PDE5 inhibitors:
Vacuum erection devices (VEDs). VEDs devices work by physically drawing blood into your penis, creating an erection. They’re often used in combination with a small band for maintaining your erection during sex.
Androgen supplements. Androgen hormones such as testosterone play a major role in regulating your libido and sexual functioning. Some research suggests that testosterone supplementation may help to treat erectile dysfunction and reduced libido from MS.
Injectable medications. These medications, which are known as ED injections, work by promoting smooth muscle relaxation and improving blood flow in your penis. They may help you to get an erection if oral PDE5 inhibitors alone aren’t fully effective.
Intraurethral medications. Also referred to as suppository ED drugs, these medications also work by increasing local blood flow and helping you to get and maintain an erection when you’re sexually aroused.
The effects of medication can vary from person to person with MS. If you have ED that’s caused by or made more severe by multiple sclerosis, you may need to try a range of drug treatments in order to find an option that works well for you.
Sometimes, making changes to medications you already use may help to reduce the severity of sexual dysfunction that’s caused by MS.
For example, multiple sclerosis is closely associated with depression, and many people with MS are prescribed antidepressants to treat their symptoms. Depression and certain antidepressant medications are both associated with sexual disorders, including reduced sexual function.
If you’re already prescribed an antidepressant, your healthcare provider may adjust your dosage or suggest switching to a medication with a lower risk of causing sexual side effects.
Psychotherapy, or talk therapy, involves collaborating with a mental health provider to overcome issues by identifying and changing troubling thoughts and behaviors. Some research shows that it can help couples affected by multiple sclerosis to improve their sexual lives.
If you have sexual dysfunction that’s caused by MS, you may benefit from taking part in therapy by yourself or by participating in couples therapy with your partner.
We offer online counseling, allowing you to connect with a licensed therapy provider from home and discuss your concerns in a private, comfortable setting.
Making certain changes to your habits and lifestyle may make some physical symptoms of MS, including sexual dysfunction, less severe. Try the following habits to improve your sexual health and function:
Maintain a healthy diet and lifestyle. The right eating and exercise habits can often reduce the severity of ED and other forms of sexual dysfunction. Try to eat a healthy, balanced diet and, if possible, to exercise when you can.
In addition to improving your sexual health, regular exercise can help manage many physical symptoms of multiple sclerosis and reduce its impact on quality of life.
Plan sex for when you feel your best. Multiple sclerosis often causes fatigue, which can affect your sexual satisfaction and desire for sex. Try to plan your sex life around your energy levels and schedule sex for when you’re feeling physically up to it.
If your female partner has MS, use a water-soluble lubricant. In women, MS often causes vaginal dryness. If your partner has MS, consider using a lubricant to reduce discomfort and make sex more pleasurable.
Our Glide Water-Based Lube is formulated to provide next-level hydration and comfort during sex with a natural sensation.
Let your partner help you. If you have reduced sensation in your genitals because of MS, consider asking your partner for more vigorous stimulation. You might find that a certain type of sex or position helps you to reach orgasm successfully.
Use techniques to deal with urinary leakage. If you’re affected by urinary leakage or bowel dysfunction, try restricting your fluid intake or using the bathroom before you plan to have sex.
If you have spasticity, experiment with different positions. Some sexual positions may help to alleviate muscle tightness. Try experimenting with your partner to find the best positions that help you feel comfortable and pain-free during sex.
Sexual dysfunction is a common issue for people with multiple sclerosis, but this doesn’t mean that you can’t still enjoy a satisfying sex life.
If you have MS and you’ve recently experienced symptoms such as erectile dysfunction, a low sex drive or difficulty ejaculating, it’s important to let your healthcare provider know.
You can also access proven erectile dysfunction medications online via our telehealth platform, including sildenafil, tadalafil and Stendra.
Interested in learning more about your sexual health? Our guide to sexual dysfunction disorder lists common male sexual performance issues and explains your options for treating them for a more fulfilling sex life and better self-confidence.