40 msfocusmagazine.org Sherry Eagle: Everything. I knew that MS stands for multiple sclerosis, but knew nothing about it or anybody who had it. Carrie Hersel: That you will first think about it all day, every day and eventually you will think about it only once every hour. Then, you eventually think about it only a few times a day and eventually you barely think about it and you just live. Keeva Mangham: Steriods are the devil. I only get them when I need them. Life With MS • Identify source and cause of pain (nerve pain, pain related to spasticity, injury, etc.) and develop a pain management strategy including relaxation, medications, etc. as appropriate Fatigue: • Optimize the timing of sexual activity for a time of daywhenyou have the most energy • Maintaining healthy levels of physical activity, a healthful diet, good sleep routines • Treatment for depression and anxiety • Some medications can help with fatigue as well Bladder dysfunction: • Timed toileting before sexual activity • Kegel exercises • Barriers such as condoms, pads on the bed • Some medications can help reduce leakage • We do not recommend water fasting given the increased risk UTI with this method Spasticity: • Stretching exercises • Different sexual positions or positioning aides such as pillows • Antispasticitymedications such as baclofen or tizanidine • Focal spasticity that interferes with sex, such as in the muscles that pull the knees together, can be helped with stretching and botulinum injections Depression and antidepressants: • Talk therapy • Healthy physical activity • Antidepressant medications • Some antidepressants may cause sexual side effects, but others may not. Tell your physician if you think one of your medications is interferingwithyour sexual function and ask if another medication might be reasonable. Conclusions Many people with MS experience changes in theirsexual function and MS maychallenge your perception of yourself and your sexuality. Sometimes changing the wayyou think about sexuality and intimacy may be necessary. For example, do you have to experience orgasm to enjoy sex? Are there other ways you can enjoy intimacy with your partner? There are manyways to help manage sexual dysfunction in MS and your healthcare team can help. What do you wish you had known about MS when diagnosed?