Drugs & Meds Blog

Impaired sexuality is common in multiple sclerosis (MS) in both sexes (McCabe 2004). In a study of 47 women with advanced MS 60% reported decreased sexual desire, 36% decreased lubrication and 40 % diminished orgasmic capacity. Genital sensory dysfunction was experienced by 62% of these women and 77% had weakness of the pelvic floor muscles (Hulter & Lundberg 1995). In other studies reduced sexual drive was reported by 29-86% of female MS patients, reduced sensation by 43-62%, reduced orgasmic capacity by 24-58%, vaginal dryness by 12-40%, and dyspareunia by 6-40% (Ghezzi 1999). Electrodiagnostic data such as cortical evoked potentials of the dorsal nerve of the clitoris (Yang et al 2000) as well as measurement of vibratory thresholds in the clitoris (Hulter & Lundberg 2005) suggest that pudendal somatosensory input is necessary for female orgasmic function, and that this may be disturbed even in early, mild MS. To compensate such a loss more direct stimulation of the anterior vaginal wall is recommended. Sacral segment dysaesthesiae may be so severe that patients may be unable to bear direct genital or non-genital contact (Lundberg 1978). Anorgasmia has been correlated with MRI brain stem and pyramidal abnormalities as well as with total area of lesions on MRI (Barak et al 1996). Zivadinov et al (2003). Correlated sexual dysfunction in MS with T1 lesion load of the pons.

Between 34 and 80% men with MS have erectile dysfunction (Vas 1969, Valleroy & Kraft 1984, Kirkeby et al 1988B, Minderhoud et al 1984, Betts et al 1994, Mattson et al 1995, Ghezzi et al 1995, 1999). Ejaculatory dysfunction is also frequent; 34-61% are affected. Orgasmic capacity is similarly reduced (29-64 %), as is sexual desire (37-86%). Genital sensory evoked potentials (SEP) abnormalities are common in men with multiple sclerosis and sexual dysfunction (Yang et al 2001). In general, sexual dysfunction correlates with bladder and bowel sphincter dysfunction, but less closely with motor and sensory dysfunction in the legs (Hulter & Lundberg 1995, Ghezzi et al 1996, Ghezzi 1999, Zivadinov et al 1999), or with disability, clinical course, and disease duration. Depression and cognitive impairment are important.

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