Reduced sexual desire

Difficulty in satisfying your sexual needs can be a source of frustration, disappointment or distress. The most important starting point for managing any sexual issues is a willingness to talk about them. Read more about talking about sexual issues

Be positive

Negative thoughts about yourself as a sexual partner can lead to a vicious circle - if you have a poor image of yourself you may generally be less inclined to initiate or engage in sexual activity, which in turn can make you feel worse. Choosing to make changes to challenge these feelings takes time and effort, but the cycle can be stopped.

Approaches such as CBT (cognitive behavioural therapy), acceptance and commitment therapy (ACT) and mindfulness can help you learn to recognise negative thoughts, feelings and behaviours and help to find new, positive ways of managing. With practise you can learn to manage these thoughts and have a satisfying sex life despite them.

Stay social

If MS is reducing your confidence, you may feel like shutting yourself off from the world - particularly if relationships suffer setbacks. Keeping in regular contact with friends and meeting other people helps to keep difficulties in proportion. If you are looking for a partner, dating websites can be a good way to build up your confidence before arranging a face-to-face meeting.

Stay active

Staying as active as you're able to is vital for both good physical and mental health. Regular exercise can help reduce stress, low mood and fatigue. This doesn't have to mean following an exercise regime or taking up a sport, activities such as gardening or photography still get you out and about and can help you to feel better about yourself.

Physical confidence

Our physical confidence can be knocked by a variety of life events, such as childbirth, illness or the general ageing process. If your body image has changed because of your MS, it can take time to learn to be comfortable with your body again. Making the most of the things you love about yourself, whilst learning to embrace your imperfections can give your self-esteem a huge boost. Remember you don't need to be perfect to be sexually attractive.

Remember your strengths

Although MS may have affected some of the things you can do, try to focus on the things you like about yourself and what you see as your strengths. You may find you have new strengths that have arisen from living with MS, such as resilience, adaptability or a sense of humour.

Sexually this is important too. It's not always what you do, but how you do it. If certain activities or positions are difficult or no longer pleasurable, explore what does work for you and concentrate on that. Don't forget your partner's needs - what do they like and how might you achieve this together?

It's not all about orgasm

Remember that sex can still be very enjoyable without having an orgasm. Expressing love and affection, being intimate and feeling aroused are just as pleasurable. Try to enjoy the process, exploring sensuality and touch, without being distracted by the need to reach climax.

Taking the focus away from sex itself is an approach sometimes used by sex therapists. Simple closeness, such as holding hands, kissing, cuddling and enjoying each other's company are vital to a relationship and can reassure both partners that you are still desirable. This distance can help you to reassess what's important to your relationship and also consider your erotic and sexual likes and dislikes without the pressure to try to instantly act them out.