If you feel easily fatigued, plan sexual activity for times when you have the most energy.
Keep the environment cool (without aggravating spasticity, which means involuntary muscle contraction) to improve energy if you are heat sensitive.
If spasticity of your muscles is a problem during intercourse, try to experiment with different positions. Side or rear-entry positions will often reduce spasticity of hip muscles.
If sensation or arousal is reduced, stimulation can be enhanced by using vibrators or other sexual aids. Remember that decreased sense of sensation is not the same as decreased feelings for your partner. You can still be loving and giving to each other.
In case of problems with bladder incontinence, empty your bladder and/or withhold fluids immediately before intercourse. Change positions to reduce direct pressure on the bladder.
If you have an indwelling catheter, it can be taped out of the way in women, and men can fold it back over the penis, and cover both penis and catheter with a condom.
If bowel incontinence is a concern, avoid intestinal stimulants such as meals or coffee before intercourse. Sexual activity can occur in the shower. Install a shower stool or chair to allow yourself to be more comfortable. Use pleasant soaps or body-gels, bathe together with your partner, and enjoy some intimate time under the warm running water.
Some medications can affect your sexual wellness. Talk to your doctor about possible side effects of the medications you are taking. Have your doctor help you time the intake of your medicine in order to minimize side effects at the time of sexual activity. For example, if you take one daily dose of a certain medicine, and you prefer to plan sexual activity for early mornings, you may want to take the medicine at mid-morning, after sex.
Women with decreased vaginal lubrication can use water-soluble lubricants (K-Y jelly, Astroglide, etc.), sold over the counter in most pharmacies.
Pain due to muscle spasticity can be reduced by bathing with warm water before sex, using pillows, and emphasizing comfortable positions.
Men with inability to maintain erections may still be able to have orgasms and to ejaculate. In order to improve the quality of your erections, it sometimes helps to empty the bladder before sexual activity. There are several ways to help have better erections. Several medications are now available on the market; vacuum devices have been useful for many; and penile implants are available for severe erectile dysfunction. Remember that erectile dysfunction does not prevent you from being sexually active and giving towards the one you love. This may be a good opportunity to explore alternative methods for providing each other sexual pleasure and release. There are many ways of being loving and intimate with your partner.
If you are severely afflicted with MS, your sexual partner should, if possible, be assisted with general caretaking.
Having a chronic disease such as MS puts a lot of stress on you, your partner, and your family. It is not surprising if at times you have a low desire for sexual activity. You may even feel depressed or anxious about your situation, further decreasing your libido.
If you can do so, try to focus on positive factors in your life, such as having a loving and understanding partner, or other family members or friends.