Getting a diagnosis of Multiple Sclerosis can be frightening and exhausting. Because there is no direct test for MS, you’ve likely gone through an extended process of recognizing symptoms and ruling out other possibilities. And when the diagnosis finally comes, adjusting to life with MS requires adaptation and patience in equal measure. That’s particularly true when it comes to sex.
While not everyone with MS experiences sexual side effects, some recent studies show over 90% of men with MS and over 70% of women will report some kind of impact on their sex lives. MS comes with a wide range of symptoms, and the impact of those symptoms on your sex life can be equally varied.
But just because MS may change the body doesn’t mean it changes the desire for healthy, satisfying sex. The good news is that, as with so many other disabilities, there are easy adaptations, aids, positions, and toys to help make fantastic sex more accessible. If you or your partner are adapting to multiple sclerosis, we’ll talk through some common issues here and discuss some positions for satisfying adapted sex.
Sex and MS: What to Expect
Sex has a unique relationship to MS because they use many of the same neural motor processes and nerve damage from MS can affect sexual function and libido. While again the symptoms will vary between individuals, there are some frequent issues associated with sex with MS that you can begin to discuss and plan around should you encounter them.
- Reduced Sex Drive: Dr. Claudia Chaves notes that MS “can dampen not only the physiological response but the feelings of sexual desire, as well.” For both men and women, that can sometimes mean a diminished interest or desire for sex, a desire for less frequent sex, or a change in your hormonal response to sexual arousal. These changes can, of course, be difficult to adjust to—which is why communication is so significant for couples with MS. A reduced libido could mean small or big changes for your sexual routine, and those changes impact both partners. Dialogue and planning will make it easier to discuss and adapt to issues of desire if they arise.
- Arousal and Sensation: Madeline Vann, MPH, says that MS can sometimes have a dampening effect on arousal and stimulation: “[It] can mean difficulty attaining or maintaining an erection (the most common sexual problem related to MS) or difficulty ejaculating. For women, it can mean reduced vaginal lubrication. Both men and women may experience hypersensitivity or reduced sensation in the genital region, and both may have trouble reaching orgasm.” We have discussed sex with ED and lubrication in more detail in the past, but below we will outline some key items that can help you and your partner adapt to issues with erections, lubrication, and arousal.
- Spasticity, Fatigue, or Pain: Vann also points out that the muscle fatigue and spasticity common to MS can make sex difficult or exhausting, as can “pain, odd sensations—such as pins and needles or tingling.” Again, communication and planning will ease the initial shock of these challenges, and there are toys, devices, and specific positions that can help make sex accessible as you deal with these obstacles.
Toys and Aids for Sex with MS
We’re going to look at some toys that fall into two general categories: toys for arousal and heightened sensation, and toys to help with positioning and stability. Now, that shouldn’t stop you from experimenting with any sex toy that grabs your interest, but these may be helpful with some of the specific symptoms of MS.
Arousal and Sensation
As we said, MS can lead to difficulty getting an erection, trouble ejaculating and orgasming, and reduced vaginal lubrication. Let’s highlight a few things:
- Lube: Lube is inexpensive and an essential sex aid for women adapting to MS. Keep in mind, too, that some women with MS report hypersensitivity in the clitoris, so it may be best to approach vaginal stimulation slowly until you know how your body is responding to the symptoms of MS.
- Cock Rings: Cock rings can be helpful in strengthening and maintaining an erection. By restricting the blood flow, they create a feeling of pressure and fullness at the base of the shaft. A metal cock ring is more restrictive (and might provide more intense sensation), while a rubber cock ring is easier to take on and off.
- Hollow Dildo: Our Everlaster harness secures to your waist and the hollow dildo fits directly over a soft or semi-erect penis. This type of strap-on will allow you and your partner to focus on the intimacy of penetrative sex rather than anxieties over keeping an erection.
Positioning ToysIf muscle pain, fatigue or spasticity is making sex difficult, a positioning aid might be a big help in reducing stress and effort on your muscles and joints.
- Sex Sling: The sling fits around your neck (or can be adapted and looped around the back of a wheelchair) and then loops over both heels, allowing you to comfortably lock your legs in a spread position in front of you with less effort and strain on your muscles.
- The Sportsheet: Velcro anchor pads with cuffs allow you to be restrained in any position that is comfortable for you on the Sportsheet—you can keep your arms and/or legs easily and gently secured on the bed, reducing the strain of trying to maintain the position unaided. You’re only as tied up as you want to be.
- Spreader Bar: A spreader bar will keep your feet and legs locked in a secure position and the same width apart, again reducing the stress, tension, and effort required for any sex position that requires that leg positioning. But since you’re not secured to the bed, your partner can grab the spreader bar and move your legs as desired.
- Sex Strap: A strap like the doggie-style strap makes a variety of positions more accessible because you can use your arms and shoulders to create rhythm and motion for sex. It should ease some of the stress on your hips and the muscle strain to the lower back and legs.
Positions for Sex with Multiple Sclerosis
The truth is that any position can be a position for sex with multiple sclerosis—it just depends on what you want and what symptoms you are experiencing. But below, we’ll look at three positions which might be particularly useful for couples having sex with MS. These highlighted positions are accessible to couples dealing with fatigue, muscle spasm, or weakness.
- Leg-Over-Leg: For this position, both partners should lay face-up on a soft bed, shoulder touching shoulder. One partner should bend their knee and lift their leg over their partner’s, and then slide their hip in as close as possible for vaginal or anal sex. This position takes stress off the neck, shoulders, and back, and since it uses the bed entirely for support, is ideal for couples contending with fatigue.
- Spooning Sex: Spooning sex is another position that is ideal for a couple dealing with MS-related muscle fatigue because it uses the bed for major support, can be achieved lying down, and leads to intimate sex that doesn’t require aggressive torsion.
Sexual Massage: Some people with MS report that orgasms can lead to painful or embarrassing muscle spasms during or after sex. A massage of your muscles before sex can help reduce spasticity, and some couples simply prefer to adapt their sexual routines to involve more touching and massage, with less of a focus on penetration or intercourse.
While the challenges of adapting your life, and specifically your sex life, to MS are real, so are the thousands of other couples with MS who have faced these same challenges and found intimacy and healthy sex lives on the other end of their uncertainties. Changes to the body can be hard to accept, but MS does not mean that your sexual identity just fades away. With healthy communication and a willingness to adapt, sex with multiple sclerosis is fun, exciting, and deeply satisfying.