Intimacy and Sexuality

Living with MS can bring changes to many areas of life including sex and intimacy. These changes can affect how your body feels, how it responds during sexual activity, and how you feel emotionally. 

When MS damages the nerves that carry signals between the brain, spinal cord, and the rest of the body, those signals can become slow or completely blocked. This can affect how much sensation you feel, how your body responds to touch, and whether you’re able to get aroused or reach orgasm. These are not psychological problems or a sign that you’re doing something wrong. They are physical changes caused by MS, not a reflection of your desire, your value, or your relationship. MS affects the body in many complex ways, including how it can change a person’s sexual response.

• Less feeling or numbness in the genitals
• Difficulty becoming aroused
• Vaginal dryness
• Difficulty getting or keeping an erection
• Trouble reaching orgasm
• Reduced interest in sex

These changes can happen to anyone regardless of gender or age and can come and go. That unpredictability can be deeply frustrating. One day things might feel fine, and the next, sensation or arousal may be completely different.

It’s normal to feel disappointed, confused, or even angry when your body doesn’t respond the way you expect or want it to. Many people also feel grief about what’s changed or worry about how it affects their relationships.

You’re not alone feeling this way, and there’s help available to you. Talking openly with your partner, your healthcare provider, or a therapist can make a real difference.

Some MS symptoms can make sexual activity feel more challenging, both physically and emotionally, affecting comfort, desire, and connection. You might feel:

• Fatigue – fatigue can lower sexual interest and make intimacy feel more difficult.
• Spasticity – muscle stiffness or spasms can make some positions uncomfortable
• Bladder or bowel problems – concerns about leaks during intimacy
• Pain – can interfere with touch or movement
• Problems with mobility or balance – can make physical closeness more challenging

These symptoms don’t have to get in the way of intimacy, but they may make you change how you usually connect. You may need to try different things and talk openly with your partner about what feels good and what works.

Sexuality is not just physical. Living with MS can affect how you feel about your body, your relationships, and your confidence. Stress, worry, grief, or depression can lower your interest in sex or make it hard to feel connected.

You might feel:

• Less attractive or unsure of yourself
• Frustrated about changes in your body
• Worried about being a “burden” to your partner
• Afraid to talk about what you need or want

When your partner lives with MS, being there for one another is important. Offer support with patience, not pity, and ask what they need rather than assuming. Intimacy might change, but closeness can still grow in meaningful ways. You’re navigating this together, and it’s okay for you to ask for support too.

Talk About It

Talking about sex and intimacy can be hard but not talking about it can be even harder. If MS has changed how your body feels or responds, opening up to your partner is one of the most important steps you can take.

Start by putting your thoughts into words, maybe write them down first if that helps. When you feel ready, have an honest conversation. Share what feels good, what doesn’t, and what’s changed for you. And don’t forget to ask your partner what they need or miss too. Finding new ways to be close by talking openly and honestly can ease worry and help you feel more connected.

Many sexual problems related to MS can be managed with the right support or treatment. So, it’s important to talk to your healthcare team if you’ve noticed changes in sexual function or if certain symptoms are affecting your relationships or confidence. This opens communication to helpful advice, medications, or referrals.

Lower Sex Drive

Some women notice a drop in sexual desire, which may come and go, or stay. It can be caused by nerve damage, fatigue, anxiety, low self-esteem, or depression. Life circumstance can play a role as well. Medications for non-MS conditions and normal aging processes can contribute.

Changes in Sensation

Numbness in the vaginal area can make sex uncomfortable or make orgasm harder to reach. Cooling the area gently with a cold gel pack or increasing stimulation through hand, mouth, or personal massagers (vibrators) can help.

Dryness

Less vaginal lubrication can make sex painful. Using lubrication can help make sex more comfortable and enjoyable. 

• Water-based lubricants are gentle, safe with condoms, and easy to wash off.
• Silicone-based lubricants are long-lasting, good for dryness, but harder to wash off.
• Avoid oil-based ones like petroleum jelly; they may cause infections.

Muscle Weakness

Weak vaginal muscles may affect sensation. Kegel exercises (contracting the muscles used to stop urinating) can strengthen the area. Do them daily but not while urinating, because that can lead to bladder problems. Many of these symptoms can also happen during menopause. Whether they’re related to MS, menopause, or both, there are ways to manage them and stay connected. 

Erectile Issues

Erection problems can happen when MS affects the nerves involved in sexual response, medication side-effects, or stress.

• Pills can help you get or keep an erection, but they only work when there’s sexual stimulation.
• Check with your healthcare team first, especially if you have heart or blood pressure issues.
• Other options include self-injection (tiny needle injects medicine into the penis) or using a vacuum pump device.

Changes in Sensation and Ejaculation

Numbness in the genital area may lower pleasure or make ejaculation harder to achieve. Some men can’t ejaculate or have retrograde ejaculation, where semen goes backward into the bladder. Extra stimulation by hand can help, and there are medications that may improve ejaculation. Talk to your healthcare team about what options might work best for you.

MS symptoms like fatigue, pain, or stiffness can make some sexual activities harder. Your body might respond differently now, and orgasm may become harder or stop altogether. But sex can still be pleasurable and meaningful in many ways—through connection, closeness, and shared enjoyment.

Cuddling, massage, or gentle touching might feel more comfortable. Try “body mapping”—gently touching different areas to see what feels pleasurable, uncomfortable, or numb. It’s a helpful way to re-learn your body and rebuild comfort, alone or with a partner.

Strengthening Communication 

Living with MS can feel like there's a third wheel in the relationship. It often makes hard conversations even harder, and frustration can grow over time. The key is to aim that frustration at the disease—not at each other. Open, honest communication helps couples stay connected, and for many, talking with a therapist can make those conversations easier, especially when things feel stuck.

Navigating Change Together

MS can bring a lot of uncertainty, symptoms may shift from day to day, making life feel less predictable. It can also change how responsibilities are shared, with one partner sometimes needing to take on more. What matters most is that each person continues to feel valued, supported, and treated fairly.

Caregivers and Intimacy

When one partner is a caregiver, it can be hard to switch gears into being a romantic or sexual partner, too. Taking breaks and having personal time away from caregiving isn’t selfish, it helps prevent feelings of resentment.

It also helps to create rituals and new sexual signals that separate caregiving activities from sex and intimacy. Small things like lighting a candle or changing the setting where you are intimate can help you both shift into a more connected, intimate space.

For additional information, please contact an MS Navigator at:
1-844-859-6789
msnavigators@mscanada.ca