b'Symptom ManagementEEnnhhaanncciinnggSSeexxuuaalliittyyaannddIInnttiimmaaccyyiinnMMSSSSeexxuuaallpprroobblleemmssiinnMMSSccaannbbeessuucccceessssffuullllyyttrreeaatteeddmmoossttoofftthheettiimmeeBy Frederick W. Foley, Ph.D.Sexual problems are very common in thepharmacological interventions. MS symptoms general population. One large scale study foundthat can interfere with sexual expression may that 43 percent of women and 31 percent ofinclude fatigue, spasticity, sensory changes in men between ages 18 to 59 experienced at leastthe body, muscle weakness, pain, and bladder or occasional sexual dysfunction. Not surprisingly,bowel problems. Some medications can interfere sexual problems are much more common inwith sexual response. Some antidepressants, MS, with up to 69 percent of patients reportingsuch as the tricyclic antidepressants and selective persistent symptoms that interfere with sexualserotonin reuptake inhibitors, can inhibit libido function. Sexual problems in MS can be dividedand orgasm. In addition, anticholinergic and into primary, secondary, and tertiary types.antimuscarinic medications can reduce Primary, secondary, tertiary vaginal lubrication, while some antispasticity medications can cause fatigue. Antiseizure Primary sexual dysfunction occurs as amedications that are sometimes used to control result of demyelinating lesions in the spinal cordtremors can also produce signicant fatigue. and brain that directly impair sexual feelingsTertiary sexual dysfunction refers to the and response. Examples include decreasedpsychological, social, and cultural issues that or absent libido or sex drive, altered genitalinterfere with sexual feelings and response. sensations, decreased or absent genitalExamples include the belief that disabled people sensations, decreased frequency or intensityarent sexually attractive, body image concerns, of orgasms, erectile dysfunction, decreasedanxiety associated with sexual behaviors or vaginal lubrication or clitoral engorgement, androle changes in the relationship, and fears of decreased vaginal muscle tone. Note that thedisappointing ones partner. Clinical depression loss of libido can also be caused by secondarycan also interfere with sexual desire. and tertiary sexual problems.It is important to note that most of the Secondary sexual dysfunction refers totime, only one or two MS symptoms interfere changes in sexual function that indirectlywith sexuality in a given person. It is also result from other MS symptoms, medical, orimportant to note that with the exception of msfocusmagazine.org 18'