[Disseminated sclerosis and sexuality]

Abstract

Since the onset of multiple sclerosis (MS) mainly occurs in younger persons between the age of 20 and 40, sexual dysfunctions have great impact on their quality of life. About 50% of all female and about 75% of all male patients complain of sexual dysfunctions. The primary symptoms among males are erective and ejaculative dysfunctions and reduced libido, while female patients mainly complain of reduced libido, problems achieving orgasm, decreased vaginal lubrication and changes in vaginal sensitivity. Secondary organic symptoms include fatigue, spasticity, muscular weakness, bladder problems, pain, cognitive and behavioural changes. Tertiary dysfunctions refer to general psychosocial problems in relation to chronic, progressive disease. One third of all couples in which either the man or the woman suffers from MS complain of problems in sexual and marital life, where especially the healthy female partner in general has sexual problems. Diagnosing and treating sexual dysfunctions in MS should ideally be carried out by a specialized "MS-team" with the core professionals being the neurologist, urologist, (neuro) psychologist and the nurse. Information about symptoms and their possible causes is an important part of the treatment, and not least learning more efficient coping strategies. Both for the patient and for the couple honest and open informative communication including information about sexual aids and perhaps also medical treatment will often result in minimizing the sexual problems and increasing quality of life.