In general women’s sexual problems are cantered on a lack of desire, arousal and orgasm. Lack of desire is the chief complaint among women. A woman’s lack of sexual interest is often tied to her relationship with her partner. It can also be triggered by family concerns, illness or death, financial or job worries, childcare responsibilities, managing a career and children, previous or current physical and emotional abuse, fatigue and depression – as well as by the MS itself. Thus the issue is often trying to deal with a range of factors in managing sexual problems. Nonetheless there is a particular set of problems that may occur as a result of the Multiple Sclerosis, particularly cantered on arousal, and subsequent problems of lubrication.
The process of sexual arousal is similar in women to that in men: in women the engorgement of the sexual organs (the clitoris and the inner and outer labia round the vagina), and lubrication by internal secretions, occur. For many women such a process is not just an aid to sexual intercourse, but also a considerable aid to sexual pleasure. In MS nervous system control of the process of engorgement is likely to fail – parallel to the process of erection in men. Furthermore, sensations in the breast and genital area may be also affected.
The usual – and it must be said – still relatively common view in such circumstances is that artificial lubrication, through the use of a lubricant such as K-Y Jelly, is sufficient to deal with problems such as vaginal dryness but, whilst such lubrication can help sexual intercourse, it may well not deal with the complex range of other issues that surround sexual arousal and fulfilment in women.
Exercises for women
Although there are several possible causes of your loss of sexual drive, and thus several possible approaches to managing the difficulty, as far as some of the physical components are concerned, the female orgasm involves – amongst other things – the contraction of several sets of muscles around the vagina. There is increasing evidence that exercising these muscles can assist in providing the conditions for better sexual responsiveness. Relevant exercises involve periodically squeezing and then releasing the pubococcygeus muscle – the one that starts and stops urination in mid flow – several times a day if possible. This can help tone the muscles, and possibly enhance vaginal sensations, which may help responsiveness.
If you have no partner, or indeed wish to attempt to do something yourself to enhance your sexual life, then there are a range of things you might try, including the use of fantasy, or sexually explicit books or magazines, and physical exploration of yourself. Some women use vibrators to provide additional physical stimulation. Although it is difficult to create sexual sensations to order, using one or other of these might help you to regain some of your libido – even if this requires more imagination than usual! Remember that some women without MS do not have perfect and completely satisfying sexual lives!
Viagra, Cialis and Levitra for women
In principle, these drugs could help to enhance sexual pleasure by promoting the engorgement of the clitoris and the inner and outer labia. Until relatively recently, although there are reports of individual women who have found Viagra helpful, there have been few systematic studies of women’s sexual response using the drug, and none in relation to women with Multiple Sclerosis. Women may feel that this again shows very particular gender priorities in the testing of such drugs.
However, although a number of studies show that women tend to report more sexual problems then men, there is less evidence that a drug such as Viagra will assist with many of their problems. By and large, the major problems for many women are concerned with desire and arousal, rather than with the engorgement of their sexual organs alone. In particular, as it has been graphically put, often ‘the most important sex organ for women is between the ears, not in the genitals’. Thus it is not at all clear that many women as might be expected will be helped by the physical effects of such drugs alone, although it is important to note, for some women with MS in particular, the local genital effects of such a drug might be beneficial when there are difficulties, for example, with lubrication. Nonetheless many drug companies over the last two years or so have begun the development and testing of drugs, which potentially may have a range of effects on women’s sexual desire, in addition to similar effects to those of Viagra.