Sexuality and Intimacy in MS – part 2 Female sexual dysfunction
In this the second of the series I will be addressing Female Sexuality.
Many symptoms of MS are invisible while others are painfully obvious. All can impact on quality of life and sense of wellbeing. While life changes affect everyone, changes from MS can directly and indirectly affect sexuality. Successful management requires creativity, communication, and patience so that a person is able to maintain his or her sexual identity.
Whether a person is in an intimate relationship or not, it is a challenge to maintain a sexual identity and take care of one’s sexual self-esteem (how one feels about oneself as a sexual being) while dealing with a chronic illness such as MS
Female sexual dysfunction is very common in women with neurological conditions, including MS. The majority of women with MS suffer from sexual dysfunction at some stage of the condition. This is estimated to be as high as 80 per cent, compared to the general female population, in which only 20-50 percent of women are affected. Sexual dysfunction has a major impact on quality of life and interpersonal relationships. For many women it is a physically disquieting, emotionally disturbing and socially disruptive disorder.
In spite of its high prevalence, these aspects of an individual’s wellbeing have been considerably neglected until recently, making female sexual dysfunction a very important but often overlooked
Symptoms most commonly reported include:
• Reduced genital sensation (48%):
• Reduced vaginal lubrication and difficulty with arousal (35%);
• Difficulty or inability reaching orgasm (72%).
Pain during intercourse is also a frequently reported symptom in
women with MS, which may be due to vaginal dryness, spasticity or sensitivity.
Changes in sensation can also interfere with sexual pleasure. Non-genital symptoms such as numbness and tingling can distract and discourage either partner. Impaired genital sensations can diminish pleasure, while heightened sensitivity may make even the lightest touch unbearable. What feels good at one time may be excruciatingly painful on another occasion.
Where diminished genital sensation occurs, you can increase stimulation through oral stimulation or use mechanical vibrators, which are widely available by mail order online
Painful or irritating genital or body sensations can be relieved with medication. Amitriptyline (Amitrip®), carbamazepine (Tegretol®) and phenytoin (Dilantin®) can be prescribed to help manage this.
It is not yet clear how helpful oral medicines like Viagra or Cialis could be for women with MS. These are targeted at sexual dysfunction in men to increase blood flow to the genitals.
Lowered libido
Loss of sex drive, or libido, can be a frequent sexual symptom among women with MS. There are currently no effective medicines for this. However, there are reports that sex therapy combined with MS symptom management and communication skills training, can be successful.
How and why MS can affect sexual functioning
Sexual dysfunction in women has many causes and effects:
• Abnormalities in blood circulation
• Lesions in the brain can interfere with the interpretation of sexual stimuli as arousing.
• Lesions in the sacral (lower) spinal cord can also cause primary sexual dysfunction, , resulting in diminished or absent clitoral swelling and/or vaginal lubrication.
• In primary sexual dysfunction, MS lesions in the spinal cord may make it difficult to sustain clitoral/vaginal engorgement during the plateau phase (between arousal and orgasm).
• In addition, sensory changes in the genitals can interrupt or diminish nerve signals that initiate and/or maintain vasocongestion at both the spinal cord and cerebral cortex (brain) levels.
Types and frequencies
It is known that approximately 80 per cent of women with MS experience sexual dysfunction at some time during the course of the disease. Some women just stop engaging in sexual relations, while others (approximately 40 per cent) have reported that participating
in sexual relations is significantly unsatisfactory.
Symptoms most commonly reported include:
• Reduced genital sensation (48%):
• Reduced vaginal lubrication and difficulty with arousal (35%);
• Difficulty or inability reaching orgasm (72%).
Pain during intercourse is also a frequently reported symptom in women with MS, which may be due to vaginal dryness, spasticity or sensitivity.
Vaginal dryness and tightness
Vaginal lubrication may be compromised by MS. The best way to cope with vaginal dryness is to apply liberal amounts of water-based lubricants (e.g., K-Y® Jelly).
Oestrogen creams may be useful for women experiencing vaginal dryness, pain or burning. Another treatment is a vaginal suppository. Ask your GP or pharmacist about what is best for you.
Conclusion
Sexual dysfunction is highly prevalent among women with MS. While identification, assessment and treatment of sexual problems can be embarrassing and complicated, addressing them is important. In this way you can identify and manage the symptoms that can have a negative impact on your personal life as well as that of your partner.
Related posts
Tags: emotions, living with ms, ms symptoms, Sexual dysfunction, sexuality self-esteem
Print This Post
Posted in