Multiple sclerosis causes erectile dysfunction in many men because it can compromise the nerves responsible for erection, libido, and male sexual response.
Multiple sclerosis is an autoimmune neurological disease in which the immune system begins to attack healthy structures of the nervous system.
The causes are still not fully understood, but genetic factors are believed to play an important role. Family history, certain genetic mutations, and infection with Epstein-Barr virus are among the main risk factors associated with multiple sclerosis.
Symptoms vary depending on the area of the nervous system affected. Erectile dysfunction in multiple sclerosis is also common, and the mechanisms involved will be explained throughout this content.
Erectile dysfunction, for example, is a relatively common condition in men with multiple sclerosis, as will be explained throughout this content.
Can multiple sclerosis cause erectile dysfunction?
Multiple sclerosis can cause erectile dysfunction in some men, being this a common alteration among patients with the disease.
According to an article on the subject, difficulty with erection can occur at 3 levels:
- Primary: related to neurological lesions caused by multiple sclerosis. These alterations affect the nerve circuits responsible for sexual function, impairing the transmission of signals involved in genital sensitivity, erection, and orgasm.
- Secondary: associated with physical symptoms of the disease, such as weakness, fatigue, spasticity, and urinary alterations, which can reduce physical disposition and make sexual activity difficult.
- Tertiary: related to psychological and emotional impacts of multiple sclerosis. Depression, anxiety, changes in self-esteem and relationship difficulties can interfere with sexual desire and contribute to erectile dysfunction.
What sexual symptoms can arise
Does erectile dysfunction caused by multiple sclerosis have treatment?
Treatment of erectile dysfunction associated with multiple sclerosis can include medications, psychotherapy, and, in some cases, penile prosthesis implant. Understand how each approach works:
Medications for erection
The oral medications for erection can be indicated when there are no cardiovascular contraindications and when there is partial preservation of neurological mechanisms involved in erection.
These medications work by facilitating increased blood flow to the penis during sexual excitement.
If oral medications do not produce the expected result, the doctor may indicate intracavernous injections, applied directly to the penis, to help achieve and maintain erection.
Adjustment in multiple sclerosis medications
Some medications used to treat multiple sclerosis can contribute to erectile dysfunction, including certain antidepressants.
Although these medications are important for controlling emotional symptoms and for the patient’s quality of life, some antidepressants can increase serotonin activity, a neurotransmitter related to well-being.
In some cases, this alteration can interfere with mechanisms involved in sexual desire, libido and erection.
For this reason, the doctor may evaluate the need to adjust the dose, replace the medication, or adopt other strategies to reduce sexual side effects without compromising the treatment of multiple sclerosis.
Psychotherapy
Psychotherapy is an important ally in treating erectile dysfunction in men with multiple sclerosis.
Psychological support can help the patient deal with feelings of anxiety, sadness, insecurity, and concerns related to sexual life, contributing to improved emotional well-being, relationships, and overall quality of life.
Penile prosthesis
The penile prosthesis can be indicated when treatments with oral and injectable medications do not produce the expected results.
The semirigid penile prosthesis is often a frequent option for men with multiple sclerosis, as its handling is simpler.
To initiate sexual intercourse, simply position the prosthesis upward, without the need for more complex activation mechanisms.
Frequently asked questions
Will every man with multiple sclerosis have erectile dysfunction?
No. Not every man with multiple sclerosis will have erectile dysfunction, which depends on the degree of neurological lesions.
Does tadalafil work?
The tadalafil can be effective for some men with multiple sclerosis, but the medication requires multidisciplinary evaluation to assess benefits and specific risks of each case.
Does the disease affect testosterone?
Yes. Multiple sclerosis can affect the hypothalamic-pituitary-gonadal axis, an area of the brain that regulates the production of sexual hormones, such as testosterone.
When to see a urologist?
The man with multiple sclerosis and erectile dysfunction should see a urologist when there is persistent difficulty with erection, changes in ejaculation, reduction in libido, or loss of genital sensitivity.
The investigation will be multidisciplinary, through hormonal evaluation to identify a possible reduction in testosterone levels and also with neurological exams.
Fill out the pre-analysis form to schedule a consultation with Dr. Paulo Egydio, a urologist specialist in erectile dysfunction treatments.
