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UK Charity
No 1131517
Multiple Sclerosis
It is important to remember that MS is only one part of a person and not the person.
MS does not represent them, it is not their identity, they are as normal as the next person.
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Sexual Issues
Despite a significant number of people with MS experiencing sexual difficulties and the negative effect these can have on quality of life, it is often a symptom that receives little attention. Many people are unable to discuss the sexual difficulties they are experiencing, generally due to embarrassment, shyness, the uncertainty of others to listen or indeed understand.
Some may consider that sexual problems are an inevitable consequence of MS and are yet another symptom that has to be endured. Others may feel that any sexual problems are unrelated to their MS. Sexual difficulties can be experienced at any time during the course of MS. Sometimes problems are minor and can be managed easily with general advice, at other times they can be more significant and require specialist input.
Types of sexual problems
Sexual difficulties may be associated with:
- Loss of interest.
- Loss of ability to perform sexual intercourse.
- The affect affect on intimacy and relationship while countering MS problems.
Sexual difficulties experienced by men may include
- Absent sexual desire.
- Decreased sexual desire.
- Erectile dysfunction -
- Changed degrees of sensation in the penis.
- Decreased frequency or intensity of orgasms.
- Premature ejaculation.
Sexual difficulties experienced by women may include
- Absent sexual desire.
- Decreased sexual desire
- Changed genital sensation.
- Decreased frequency or intensity of orgasms.
- Decreased vaginal lubrication.
- Decreased clitoral engorgement.
- Decreased vaginal muscle tone.
- Pain on penetration.
- Inability to discuss the problem with their sexual partner.
Some may experience sexual difficulties as a result of other MS symptoms such as:
- Bladder problems.
- Fatigue.
- Spasticity.
- Prescribed medications.
Living with MS, especially when it is disabling, can create an immeasurable effect
on someone's self-
Management
Not every sexual problem is due to MS and many of the difficulties described by people with MS also occur in the general population such as:
- Anxiety.
- Sleepless nights.
Treatment of MS related sexual issues can involve counselling and finding new ways of being intimate that are better suited to the individual's situation.
- Alprostradil is a vasodilator for the treatment of erectile dysfunction.
- Also known as -
Caverject, Caverject Dual Chamber, Muse, Viridal Duo.
Alprostradil may be considered where general and specific factors that cause or worsen
erectile dysfunction have been assessed and there has been no response to Sildenafil
-
How Alprostradil works
Alprostradil works by causing blood vessels to expand, increasing blood flow. When this is administered to the penis the increased blood flow results in an erection.
Alprostadil in the form of MUSE is administered by application into the opening at
the end of the penis -
Side effects and contraindications
Common side effects can include:
- Dizziness.
- Headache.
- Pain in the penis or urethra.
- Prolonged erection lasting more than one hour. [1]
Vasodilator drugs are medications that get their name from the Latin words "vasa," which means "vessel," and "dilate," which means "to make wider."
These drugs work by relaxing the smooth muscles that line the walls of blood vessels
-
The following substances may intensify the effects of vasodilators and lead to severe low blood pressure:
- Alcohol, which is itself a vasodilator.
- Medications for sexual dysfunction.
- Nicotinic acid, a form of vitamin B3 that is sometimes used as a cholesterol-
reducing drug. - Grapefruit juice -
which interferes with the liver's ability to rid the body of vasodilators and many other substances. This could lead to a buildup of vasodilators to dangerous levels in the body.
Substances that can counteract the effects of some vasodilators and increase blood pressure include:
- Aspirin or other nonsteroidal anti-
inflammatory drugs (NSAIDs) - Nicotine
- Narcotics -
prescription- strength painkillers. - Some over-
the- counter medications for cough, colds, flu, sinus problems, hay fever, and asthma, as well as those for bloodshot (red) eyes or appetite control, may adversely react with vasodilators.
The inability to discuss sexual problems is not confined only to those with MS, it is a common problem.
If you're using vasodilator drugs, avoid drinking grapefruit juice.