MS & Sex – Part 2: Reclaiming Intimacy, Pleasure & Practical Tips for People with MS

⚠️ Please read with care: This blog shares personal, sometimes painful experiences. My intention is to support and speak honestly not to harm. I’m not a professional, just someone who understands how hard it can get. If you're struggling, you're not alone please reach out for professional help.

Beyond the Awkward Truth: Reclaiming Intimacy, Pleasure & Connection

If you read Part 1, you already know we ripped up the polite pamphlet version of “MS & sex” and talked about the real, awkward truths: sexual dysfunction, libido loss, nerve changes, fatigue, and how multiple sclerosis can affect intimacy on every level primary, secondary, and tertiary.

Part 2 is your guide forward. We’ll cover practical ways to work around MS-related sexual problems, from cooling hacks and position adaptations to communication tools, pelvic floor therapy, and adaptive-friendly toys. More importantly, this is about hope — proving that intimacy, touch, and pleasure are still very much possible with MS, whether you’re dealing with numbness, spasticity, or just the psychological toll it can take.

You Are Still You

Your worth is not measured in erections, orgasms, stamina, or how many positions you can pull off without pulling a muscle. You are not “less” because your body works differently now.

Sexuality evolves for everyone. MS just forces the evolution sooner — and pushes creativity higher.

Touch Is Medicine

Even if fireworks aren’t what they were, touch still heals. It can lower stress hormones, boost oxytocin (the “connection” chemical), and protect you from the isolation chronic illness can create.

Try non-goal touch: morning cuddles, holding hands during TV, skin-to-skin naps. If it turns sexual, great. If not, it still counts.

Your MS-Friendly Bedroom Toolbox

• Cool the scene: fan, cooling packs, or a quick shower to prevent heat-triggered symptoms.
• Pillow engineering: wedges/bolsters/rolled towels to reduce strain and spasticity.
• Pick your moment: align intimacy with your energy curve — mornings are allowed.
• Use the gear: water-based or silicone lubes; lighter, hands-free, or easy-grip toys.

Rebooting the Brain–Body Connection

Fatigue, anxiety, brain fog — they can mute desire. That’s not “you losing interest”; that’s a busy brain.

• Prime arousal with fantasy, erotic audio, or slow sensual touch before “going for it.”
• If focus drops, laugh. Humour turns frustration into closeness.

This Is a Team Sport

If you have a partner, MS affects both of you.

• Be clear about what works and what doesn’t — don’t make them guess.
• Let them share their fears without judgement.
• Reassure them you still want them, even if the way you show it has changed.

Redefining What “Counts”

Intimacy isn’t all-or-nothing. It’s the shared coffee in bed, the ridiculous laugh that ends in tears, the hair stroke while someone drifts off. These small moments are the glue; they make sexual moments richer when they happen.

FAQ: MS, Sex & Intimacy

How common is sexual dysfunction in multiple sclerosis?
Sexual dysfunction is extremely common in MS, affecting around 40–80% of women and 50–90% of men with the condition. These issues can appear early or later in the disease course, and they’re not “just in your head” — they’re a recognised symptom of MS that deserves proper attention and treatment.

What causes sexual problems in MS?
MS-related sexual changes are often grouped into three categories:
Primary sexual dysfunction – nerve damage from MS lesions affecting sensation, arousal, lubrication, orgasm, or erections.
Secondary sexual dysfunction – other MS symptoms like fatigue, spasticity, pain, bladder or bowel problems, and side effects from medication.
Tertiary sexual dysfunction – emotional and psychological factors, such as depression, anxiety, body image changes, or relationship stress caused by living with MS.

What helps with intimacy and sexual function in MS?
Cooling strategies to prevent symptom flare-ups, adaptive positions with pillows or wedges, timing intimacy for when you have more energy, and using the right lubrication or adaptive-friendly sex toys can make a difference. Pelvic floor therapy, sex therapy, and open communication with your partner are also proven to improve sexual satisfaction for people with MS.

Is intercourse the only form of intimacy?
Not at all. Intimacy with MS can include mutual massage, skin-to-skin contact, oral sex, using sex toys, or simply non-sexual touch that builds connection. Focusing on pleasure and closeness — rather than a specific sexual “goal” — often leads to a richer, more relaxed sex life.

Are there tools to help identify what’s going wrong?
Yes. Healthcare providers sometimes use the Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-19) to identify problems across primary, secondary, and tertiary causes. Bringing this up with your neurologist or MS nurse can help start a more informed, targeted conversation about your sexual health.

Final Word

MS changed the map, not your right to pleasure. There’s plenty of territory left: new paths, new ways to connect, new ways to feel at home in your skin.

You deserve pleasure, touch, and intimacy that makes you feel wanted, whole, and human. The script changed — the story is still yours.

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I write in ink and fury, in breath and broken bone.
Through storm and silence, I survive. That is the crime and the miracle.