Sexuality and intimacy in MS – part 5 Tertiary
A more in depth discussion will be available from AVoiceForMS.com in the near future.
In the last of the series I will be addressing tertiary causes of sexual dysfunction.
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.
Sexual changes in MS can best be characterised as primary, secondary, or tertiary.
Primary sexual dysfunction has been dealt with in parts 2 and 3. Secondary was dealt with in part 4. In this article I am going to deal with tertiary sexual dysfunction but I am simply going to lay out the symptoms. A more advanced course is available which covers possible courses of action to take given the symptom.
Tertiary sexual dysfunction
The onset of MS can alter a person’s perception of himself or herself as an individual, altering sexual development and expressions of sexuality and it can have a negative impact on sexual and intimate functioning. These are known as the tertiary sexual problems of
MS, derived from the resultant psychological and social changes, as distinct from the direct neurological dysfunction (primary sexual problems) and the symptoms of MS (secondary sexual problems).
People with MS can find it difficult to see themselves as being “sexual”, having sexual thoughts, desires and needs whilst at the same time identifying with the role of a person with a chronic illness.
Individuals see themselves as complete persons in terms of their roles within families, friendship circles, sporting clubs, activities and occupations. Any feelings of loss of control over events or unplanned changes because of MS can affect one’s confidence and self-esteem and alter the dynamics of relationships, especially close and intimate ones.
Dealing with the impact of MS and symptoms can leave one neglecting the emotional and psychological aspects of life in general. Simply attending to the physical needs of life’s daily activities can leave little time or energy for emotional contemplation and intimate relationships. This is particularly evident if fatigue is experienced as a symptom of the MS.
What you can do
If you experience problems with intimacy and sexuality, you need to allow yourself time to assess your overall situation and to feel confident about communicating any difficulties to those close to you.
Counselling can help individuals to explore feelings and facilitate discussion in a respectful and professional way. You can identify negative emotions such as guilt, anger and resentment, see them in context, and work through them, in a non-judgemental environment.
Here you can discuss topics, perhaps seen as too embarrassing to discuss alone, in an open and supportive atmosphere. Strategies for improving the situation, or adopting new ways of considering and developing sexuality, can be introduced.
Drugs that affect sexual functioning
Some people with MS may experience depression and/or anxiety, and medications prescribed for these conditions can affect sexual functioning.
The drugs used to treat depression and anxiety belong to a family called ‘Selective Serotonin Reuptake Inhibitors’ (SSRIs). Commonly prescribed SSRIs include Fluoxetine, Sertraline, Fluvoxamine, Paroxetine, Citalopram and Venlafaxine.
Conclusion
Sexuality is an important aspect of human life and must not be neglected when considering the impact of MS on an individual.
Increasing awareness and acknowledgement of the effects of MS on sexuality has greatly improved the management and treatment options available for people with MS experiencing difficulties in this area.
While this is often a difficult and sensitive subject, discussing sexual difficulties with your GP or neurologist is the first step to identifying effective strategies to manage any problems, and to support your need for sexual expression.
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