Multiple sclerosis affects men in ways that are different from women, yet men’s experiences with MS are often under-recognized. The information on this page is designed to speak directly to the unique physical, emotional, and social challenges, and to offer practical tools to stay healthy, engaged, and confident in your daily life.
Biology and MS: What’s Different for Men
MS affects each person differently, and in relapsing MS, men may experience faster progression than women. In primary progressive MS, however, progression tends to be similar for both men and women. Researchers believe that the differences between men and women in relapsing MS is a combination of biological, lifestyle, and environmental factors contribute to this.
Hormones
Hormones like testosterone may play an important role in MS for men. Researchers are studying how testosterone and other sex hormones affect the brain and disease progression in men with MS. Testosterone may help protect the brain and nervous system, and as men age and testosterone levels naturally decline, that protection might lessen. Understanding these hormone-related differences may help guide future ways to support cognition, physical function, and overall brain health.
Immune System and Repair Processes
Studies show that men with MS have more neurodegeneration (nerve damage) in the brain and spinal cord than women. This difference seems to come from how the immune system responds to inflammation and how the brain repairs itself. Inflammation from MS lasts longer, and the brain may show more areas where myelin is damaged. This ongoing immune activity can make it harder for the brain to recover.
Men also tend to have higher levels of iron in areas of the brain that control movement and cognition. Too much iron can increase stress on brain cells and lead to further damage.
Researchers are still studying why these differences happen and how factors like Epstein–Barr virus (EBV), diet, body weight, and smoking might affect how MS progresses differently in men and women.
Work and Identity
Identity can be closely tied to one's career and the ability to provide for their family. When MS affects energy, mobility, or cognition, that connection to work can feel challenged. It can be hard to accept, but it can also be seen as an opportunity to rethink your role, rediscover your strengths, and explore new ways to contribute at work and at home.
When your work is a core part of who you are, changes brought on by MS can feel personal and challenging. But they don’t erase your experience or your value. Many men find new ways to apply their skills, mentoring, leading, teaching, or adapting how they work.
Staying engaged in meaningful work, whether through paid employment, volunteering, or creative projects helps maintain confidence, routine, and a sense of contribution.
Some people wait to tell their employers about their diagnosis because they worry about being judged or treated unfairly. You’re not obligated to disclose your diagnosis, but depending on the role (job duties) some symptoms or disability can affect your ability to work safely or consistently.
Job accommodation, like adjusting your schedule, working from home, or shifting tasks, can help you feel more satisfied and stay in your job longer. For more information about job accommodation see the Job Demands and Accommodation Planning Tool (JDAPT).
Making Your Space Work for You
Explore ways to make your living space more functional for you if MS has affected how you go about daily routines. Even small changes can help things feel more manageable and better suited to your current needs. If you're curious about what could work for you, an occupational therapist can offer suggestions tailored to your preferences and how you live day-to-day.
Family and Relationships
Mental Health and Masculinity
Living with MS can affect your mood, confidence, and sense of identity, and many men find it hard to talk about these emotional changes. There’s often pressure to “stay strong,” but strength also means knowing when to reach out.
Depression, anxiety, irritability, and withdrawal are common and treatable. Speaking up helps your care team connect you with practical support like counseling, peer groups, medication, or stress-management strategies.
Sexual Health
Sexual function can change with MS, but it’s often not discussed, especially among men. Between about 60 to 70% of men with MS experience some type of sexual problem (erectile problems, ejaculation issues, or reduced libido) over the course of the disease. ¹ This can be caused by nerve damage, fatigue, depression, or side-effects of medication.
There are effective treatments and therapies available. Be sure to bring this up with your neurologist or primary care provider, because sexual health is part of your overall well-being. Read Intimacy and Sexuality for more information.
Shifting Roles at Home
MS may shift how responsibilities are shared, from household chores and roles to emotional support. These changes can bring feelings of frustration, guilt, or loss. Open conversations and a flexible mindset can help families adjust together, strengthening connection through mutual understanding and teamwork.
Parenting with MS
Whether it’s managing fatigue, mobility, or cognitive changes, parenting with MS sometimes requires creativity and planning. Tools like energy-saving routines, assistive devices, and honest conversations with kids can make a big difference. Read Talking About MS: A Guide for Families for more information.
Aging with MS
As men with MS age, taking care of mental health, especially treating depression, is important because it helps maintain healthy habits, like exercise, good nutrition, and social connections, which can protect overall health and independence. Read Aging and MS for more information.
Supporting Brain Health
Daily habits that support brain health can help you feel more focused, energized, and emotionally balanced. These behaviours also play a role in maintaining mobility and independence over time.
- Have regular checkups with your primary care provider for routine screenings like blood pressure, cholesterol, diabetes, and cancer — and talk about lifestyle changes that support your overall health, like quitting smoking or maintaining a healthy weight.
- Stay physically active with movement that feels good. Read Physical Activity and MS for more information.
- Eat balanced meals that fuel your body and brain. Read Nutrition and MS for more information.
- Challenge your mind through reading, puzzles, learning, or creative hobbies.
- Connect socially with friends, family, or community groups to reduce feelings of isolation.
- Practice healthy sleep habits. Many people with MS experience sleep challenges like insomnia or frequent waking, so creating consistent routines, like winding down before bed and limiting screen time can help encourage more restful and reliable sleep.