‘Uncomfortable topics’ can affect quality of life for people with multiple sclerosis; treatments can help.

Story by: Sara Thompson on December 19, 2022

Multiple sclerosis (MS) affects almost 1 million Americans, according to the National Multiple Sclerosis Society. Since MS affects your muscles and muscle control, sometimes the muscles of the bladder and sex organs are affected. There are treatments that can help incontinence and sexual issues in MS patients.

“These are sometimes uncomfortable topics for people to discuss with their doctors,” said Anna V. Bite, D.O., neurologist with Norton Neuroscience Institute. “But these are issues that affect a person’s quality of life, so it really is important to address them.”

Bladder issues and MS

MS prevents the brain and muscles from communicating normally. The muscles of the human urinary tract can be affected by MS, resulting in incontinence (inability to hold urine), difficulty fully emptying the bladder and frequent need or urgency to urinate.

What can I do about bladder issues if I have MS?

There are some medications available for some bladder issues. There are also many lifestyle interventions and techniques you can try:

• Limit bladder irritants including coffee, tea, citrus juice, caffeine and alcohol.
• Practice pelvic floor exercises either at home or with a physical therapist.
• Restrict fluids two hours before bed.
• Drink enough water that urine is a pale yellow color or almost clear.
• Timed voids: Urinate every two hours while awake.

Sexual issues and MS

Sexual dysfunction is very common in patients with MS. According to Dr. Bite, about 91% of men and 72% of women with MS report sexual issues.

“This is an area that can have a profound impact on your quality of life and the quality of your relationships, mood, self-esteem and confidence,” Dr. Bite said.

Sexual dysfunction comes from a variety of sources. Neurological issues include erectile dysfunction, decreased libido, difficulty reaching orgasm and premature/delayed ejaculation. MS symptoms can affect a patient with fatigue, muscle spasms, and bladder/bowel control issues. Another kind of sexual dysfunction deals with body image and one’s perceptions of one’s body, as well as changes in one’s roles between partners.

“An example of changes in role might be a person with MS who suddenly cannot work a job and feels like they are not contributing to the household,” Dr. Bite said.

What can I do about sexual dysfunction if I have MS?

Depending on the source of the dysfunction, there are many ways to address sexual issues in MS patients, including:

• Medication — either starting or stopping medicines that affect your symptoms
• Tools such as lubricants, vibrators or other methods
• Cognitive behavioral therapy, couples counseling or other method of “talk” therapy
• Managing MS symptoms — for example, taking medications to reduce muscle cramps

The most important step to take is talking to your doctor.

“If you are uncomfortable discussing these issues, you can write a letter or a list of questions for your provider,” Dr. Bite said.

For sexual dysfunction, you could answer this questionnaire and give it to your doctor as a starting point for a conversation.

Learn more and watch a full presentation on this topic by Dr. Bite: