Talking about sexual problems

Whether you're in a relationship or not, difficulty in satisfying your sexual needs can be a cause of frustration, disappointment and distress. The most important starting point for managing sexual problems is to be willing to talk about them. Talk to someone that you feel safe and comfortable with. This may be your partner, a friend or a health professional such as your GP or MS nurse. You may prefer to discuss any issues more anonymously via a helpline or online group.

Talking to partners

If you are in a relationship, it's important to reassure your partner that they're not the source of any sexual difficulties. Without this understanding, they might interpret changes in desire or arousal as a reflection on themselves - a sign of waning affection or your loss of interest in them sexually, they may feel rejected or that they've failed you in some way. If you don't discuss these issues, it can lead to cracks in the relationship that might be irreparable by the time you eventually seek help.

The chance of successfully managing issues is improved if partners are involved. Communication is vital and helps in adjusting and adapting to treatments which might require a more planned, or less spontaneous approach to sex. If partners know what is happening and why, it allows for sex to be enjoyed when you both want to.

When entering a new relationship, you may feel reluctant to admit to anything that you feel might undermine your attractiveness. A discussion about sexual dysfunction may not seem to be a persuasive chat up line. Whilst not mentioning difficulties with sex may work in the short-term, if the relationship becomes more serious any issues will become apparent and could lead to disappointment and conflict.

MS Clinical Specialists Lesley and Denise answer your commetns and questions about sex.

Talking to professionals

Although talking about sex with health professionals may feel uncomfortable or embarrasssing, sex is an important part of life. Issues that affect your sex life should be taken as seriously as any other MS symptoms.

A healthy approach is to be as open about sexual problems as you would be about any other MS symptom - many health professionals are used to talking about these matters and have probably heard it all before. If the health professional you talk to isn't well informed or skilled at dealing with this topic, they should be able refer you to someone who is. If they don't, then you can ask for a referral to someone better able to help you.

There are people within the health service with expertise in managing sexual issues. Most GP surgeries have access to someone with experience; it may be one of the GPs or the practice nurse. MS specialist nurses and therapists are aware of the sexual problems associated with MS and can provide advice or an appropriate referral. Continence nurses are also familiar with sexual issues and urology specialist nurses are skilled in managing both continence issues and male sexual problems.

Some ideas for raising the subject of sex

If you do decide to approach your MS nurse or another health professional, you may find it helpful to note down your problems and questions on a piece of paper as it is easy to forget important points when you are talking about a sensitive subject like sex. It may increase your confidence to rehearse what you are going to say.

Before you attend your appointment, it might be helpful to think about the actual words you want to use when you are discussing sexual difficulties. If you choose words that you feel comfortable with, this may help you to relax. This might be more general terms such as 'private parts', 'down below' or 'nether regions', or you might prefer more biological terms to make sure there's no misunderstandings.

Ideas from people with MS

  • "Doctor, I'd like your help. I'm having problems with my sex life, could it be my MS?"
  • "I'm finding that MS is getting in the way of intimacy, is that something I can talk to you about?"
  • I start by apologising for bringing the subject up. This seems to give me permission to talk about it and it then becomes much easier.
  • I favour the direct approach - something like "Sex just isn't what it used to be" something that compares before with now.

Ideas from health professionals

  • Take a list of issues to an appointment and include any sexual difficulties. Either read the list or hand it to the health professional.
  • Raise sexual issues during a general discussion about bladder or bowel symptoms, these may be easier to talk about and they are often related.
  • An explicit statement like "I am having problems with my sexual relationship" or "I am having sexual difficulties" will help the professional more than vague statements like "My partner is disappointed with me".

For some people, counselling can help. There are a limited number of psychosexual counsellors within the NHS who can offer specialised help, although more general counselling services can help address issues within relationships and find ways to face difficulties together. The College of Sexual and Relationship Therapists (COSRT) has a list of therapists.

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