38 msfocusmagazine.org Having and enjoying a healthy sex life is an important part of living well for many people. Furthermore, sexual expression has health benefits including reducing stress, pain, depression, heart disease, prostate cancer and vaginal atrophy, among other benefits. Sexuality is influenced by a range of factors, includingphysiological,psychological,physical, cultural, and spiritual – some of which can be affected by multiple sclerosis. Between 70 to 90 percent of men and 40-70 percent of women report changes in sexual function at some point in the course of their illness. The importance of psychosocial health and sexuality should not be underestimated. The neurophysiology of sex Sex is complex! The sexual response cycle is divided into several phases including the excitementphase(initialarousalwhichincludes penile erection, vaginal lubrication and engorgement), the plateau phase, orgasm, and resolution. The nervous system is involved in all aspects of sexuality, from sexual arousal and attraction to orgasm and bonding. Networks within and between the brain, spinal cord, and peripheral nerves are involved in sexual function. Networks within the brain interpret sensory information and assign them value, including pleasure, pain, etc. The brain allows us to perceive the world around us and integrates our preferences and experiences with our senses, including visual, auditory, gustatory (taste), olfactory (smell) and tactile (touch) stimuli. Nerves in and under the skin respond to touch, pressure, vibration, and temperature and then send messages to the brain via the spinal cord. The spinalcordalsoplaysacriticalroleinregulating our perception of tactile sensations and pain. Motor areas of the brain communicate with the spinal cord in order to regulate muscle tone and movements. Theautonomicnervoussystemisresponsible for controlling bodily functions that do not involve ourconscious input, such as breathing, heartrate,bloodpressureanddigestivefunctions. The autonomic nervous system also regulates sexual functions such as erection, vaginal lubrication and orgasm. Sexual function with MS Erectile dysfunction is the most common problem among menwith MS, but otherissues suchasdecreasedsensation,difficultyachieving orgasm, and problems with ejaculation also occur. Among women, difficulty achieving Life With MS Sexuality and Intimacy With Multiple Sclerosis By Michael J. Bradshaw and Dr. Maria Houtchens