b'certain types of erectile dysfunction, MS-related Use educational books, handouts, and videos sexual changes do not affect fertility. Mento initiate discussion. and women with MS need to make the same Do not accuse, criticize, or blame your partner. kinds of family planning and contraceptiveUse I feel, I would like language instead decisions as any other couple.of You dont language. The good news about sexual problems in Expect that some sexual requests will be MS is that they can be successfully treatedrejected. Remember this does not mean most of the time. The rehabilitation of sexualrejection of you as a person. function includes education and support to Be aware that sexual feelings and preferences promote active problem-solving and goodchange, especially as MS symptoms uctuate. medical symptom management. For example, Use nonverbal communication assertively if depression is present, successful treatment(take their hand and show how you like to of depression will frequently restore sexualbe touched). drive. However, it is important to ask your prescriber to give you an antidepressant that Do not expect your partner to do anything does not interfere with sexuality. Cognitive- unless you explicitly ask them or show them behavior psychotherapy is found to be very(no mind reading). effective in several studies at alleviating Do not expect perfection. depression and anxiety in MS. This may be aMapping the bodyreasonable approach to address these painfulWe frequently advise couples experiencing emotional states.sexual difficulties to conduct a body-mapping Where to begin exercise. MS can cause many changes in If you have noticed a loss in your sex drive,the body and this exercise is designed to pleasure, or response, begin by discussing iteducate the couple about the body, to improve with your partner and healthcare team. Manycommunication, and to enhance intimacy and healthcare providers will not ask you aboutphysical enjoyment. your sexual function, so it is critical that youThe steps are: bring it up to them and indicate you wantBegin by being in a safe, comfortable setting help with this. Several studies have foundand temperature. that education about sexual function in MS and available treatments lead to signicantBoth partners remove clothing. improvements and satisfaction with sex.Each partner will take turns systematically There are many books, videos, websites, andtouching the other, beginning by touching pamphlets available that persons with MS canthe top of head and systematically moving use to educate themselves about enhancing theirthe touch down the body. It is important that the sex lives. Start by contacting MS organizationsperson receiving the touch provides feedback for educational pamphlets on sex and MS. Readto the partner about changing the pressure, the materials or watch the videos togetherspeed, rhythm, and pattern of touching to with your partner and discuss together. If youmaximize sensory pleasure. The receiver also are uncomfortable talking about sex, someshould only focus on their pleasure, not the guidelines include:pleasure of their partner. It is important toAgree on when and where its most comfortableinitiallyfocusonnongenitalareasofthe to talk about sex.body. The idea is to enhance understanding 19 msfocusmagazine.org'