The bladder, the bowel, and MS: what are the symptoms?
Multiple sclerosis (MS)
causes damage to the nervous system, disrupting messages from the brain, and can therefore interfere with a wide range of bodily functions. Bladder and bowel functioning are particularly susceptible to disruption.
Which bladder symptoms are there?
When your MS causes a lesion on a nerve that impacts the normal function of the bladder a variety of symptoms can occur. We have made a simple overview for you.
Which bowel symptoms are there?
When a lesion occurs on a nerve that is connected to your bowel function, this can be impacted. The symptoms can vary so it may be a good idea to get an overview so you know what to look out for.
3 out of 10 people with MS have had a bladder infection in the last year
Find out how a bladder infection may be related to your MS and what the possible symptoms are.
Bladder, bowel and sexual dysfunction when living with Multiple Sclerosis
Some people find that when living with Multiple Sclerosis, they become dissatisfied with their sex life or experience some level of sexual dysfunction. Simply put, issues may arise that interfere with you enjoying sexual activity. Together with bladder and bowel problems, this is frequently linked to a lower quality of life.
This article explores the connection between the bladder, the bowel, and sexual dysfunction in MS, and explains how sexual problems may manifest in both women and men living with MS. If you think your quality of life is impacted by sexual dysfunction, it is recommended you reach out to your doctor for support.
How are bladder, bowel, and sexual dysfunction connected?
Multiple Sclerosis is a neurological disease which can have many symptoms, including bladder, bowel, and sexual problems. It can cause lesions in areas of the central nervous system which are home to the control centre for pelvic organs such as the bladder, bowel, and sex organs.
When talking about sexual dysfunction in MS, it can refer to both the impact MS can have on how your body reacts during a sexual response, as well as further symptoms of MS that can indirectly complicate your sexual relationships.
At times, MS can lead to physical altered genital sensation, problems with arousal or orgasm, decreased libido (i.e., desire for sex), decreased vaginal lubrication, and erectile dysfunction.
Nonsexual symptoms may also affect your sexual responses and can cause further challenges when maintaining a healthy sex life. This could include symptoms like fatigue, tremor, or bladder and bowel issues which may interfere with sexual responses.
Together, these issues may complicate a sexual relationship. It is possible they can lead someone to develop a negative self-image or make it harder to communicate with your partner. For some, opening up about concerns regarding intimacy in a relationship is hard, and these negative feelings can add an extra challenge. It is therefore important to recognise these symptoms and try to address these concerns where possible. In some cases, seeking professional support together with your partner can help address dissatisfaction in a relationship and discussing these concerns with your nurse or doctor can help you get practical advice on how best to proceed.
Reduced libido and support with sexual dysfunction
A common problem regarding a healthy sex life when living with MS is a lack of sexual interest. This can affect both men and women. A reduction in your desire for sex may not be something you immediately notice, but reflecting on your sexual functioning before your MS diagnosis and comparing this to your recent activities may help you to see if your libido has weakened.
If you have a significant other, sexual problems and reduced libido can be a major stressor. Sexual counselling may therefore aid in the treatment of any psychological factors that are inhibiting intercourse and also help to develop a better understanding between partners, thereby promoting intimacy.
Non-sexual changes to the body such as decreased mobility, spasticity, or fatigue can also add constraints on sexual activity and affect both men and women. If you have an understanding and stable partner, you may wish to include them in discussions with your MS nurse or doctor. These symptoms can play a role in both what positions are physically possible for you as a couple and the levels of sexual desire. Discussing these topics together may help to get you both on the same page and increase your understanding of each other’s concerns and experiences.
Bladder and bowel issues, and sexual relationships
Living with bladder and bowel issues may add complexity to your sex life. Worries about incontinence may lead you to avoid physical intimacy. Transanal irrigation (Link) and/or treatments for urinary incontinence (link) may therefore be sought out as a way to manage these symptoms and can be discussed with your healthcare practitioner. Restricting fluid intake for an hour or two before sex, performing intermittent catheterisation or voiding just before sexual activity, and avoiding alcohol, caffeine and tobacco, may also help to reduce urinary incontinence.
Raising your concerns about your bladder and/or bowel health with your doctor may also lead to discussions regarding potential sexual problems, as well as how to potentially alleviate these and help increase comfort during physical intimacy.
Gender specific sexual dysfunctions when living with Multiple Sclerosis
Multiple Sclerosis can lead to bodily changes that may impede intimate relationships. But, as male and female bodies are different, the affect MS can have on physical sexual functions can also differ, meaning different treatments may be sought out.
Sexual dysfunctions among women with Multiple Sclerosis
One of the greatest physical barriers to sexual activity for women living with MS is urinary incontinence. If you are concerned your incontinence is preventing you from being intimate, you may want to talk to your nurse or doctor about possible treatment options.
It is not uncommon for women living with MS to struggle with decreased sensation, decreased or absent orgasm, and difficulty with arousal. A sexual response for women can be less dependent on physical arousal than for men and more intertwined with relationship dynamics. Time may therefore be wisely spent considering how you relate to your other half or sexual partners, both physically and emotionally. You may choose to do this either alone, or with the support of sexual counselling.
MS can also lead to additional physical issues, such as reduced vaginal lubrication, in which case additional lubricants may be used. Problems with positioning and spasticity may also play a role in complicating physical intimacy.
Urinary tract infections may also be more common, making it important to practice sexual hygiene when engaging in physical intimacy. Passing urine and washing gently with warm water after sex can help reduce the amount of bacteria present, reducing the risk of contracting a UTI.
Sexual dysfunction among men with Multiple Sclerosis
Some sexual symptoms are also specific to men with Multiple Sclerosis. These include premature ejaculation, erectile dysfunction, and decreased sensation. Some men take medicines to help them achieve erections and this can allow you to be more spontaneous. Other alternatives may include vacuum erection devices or a penile prosthesis. For specific information regarding the treatment of these symptoms and what may be most suitable for you, it is recommended that you seek advice from your doctor.
Recognising the impact MS has on your sex and intimacy
It can be hard to recognise when intimacy and sexual relationships in your life are impacted by your MS. Whilst symptoms of sexual dysfunction are rarely life threatening, they nonetheless can have a significant impact on your quality of life. Reflecting on your own experience by asking the following questions may help you to make sense of how your MS affects your sexual relationships:
- How was your sexual functioning before your diagnosis and has your experience changed
- Are you able to have orgasms?
- Do you have decreased genital sensation?
Women may further want to consider:
- If intercourse is painful for you
- If you have problems with vaginal dryness during intercourse
Men may further want to consider:
- If your erections are firm enough to have penetrative sex
- If you can maintain an erection during penetrative sex