I first heard these words uttered on an Oprah show long ago, where the show's topic was something like "When Men are Too Tired for Sex".  Oprah would replay the audio of a man's deep southern voice saying "Oooh baby I'm so tired" over and over.  Oprah, as well as the audience members, giggled in response. 

Whether you are a man or woman, who can relate to saying this phrase?  If you or your partner has Multiple Sclerosis, I guarantee you have either said it or heard it before.  And it really is no laughing matter.  MS can definitely put a damper on intimacy at a time when you need that connection the most.

How can MS affect sexual relations?  Let me count the ways.

• Fatigue:  In an article entitled, "Beyond Just Tired:  Figuring out MS-Related Fatigue" author Christine Haran states that "Fatigue affects up to 87 percent of people with MS, and about 40 percent say it is their most disabling symptom-and one that interferes with their work and social lives."  And I am going to add that it also affects our sex lives.  It is difficult to feel emotionally or physically capable of vigorous intimacy when you feel so darn weary.

• Some people with MS experience numbness or even pain in sensitive regions of their body.  These sensory changes can make sexual relations a mine field to deal with.  It may be difficult to know on any given day what will bring pleasure and what will cause discomfort.

• Spasticity or tremors in muscles can make certain positions awkward if not impossible.  Certain movements may be difficult or cause pain.

• Depression is often a symptom of having MS and this can certainly diminish sex drive and desire.  Some people may feel feel worried about sex and this can create performance anxiety.  For others depression can lead to feelings of low self worth and a discomfort with body image due to the physical changes brought upon by this disease. 

• Since sexual arousal is dependent upon the messages sent via the central nervous system to sexual organs, the myelin destruction caused by MS can impair these signals.  What can happen as a result?  For women it can cause a lack of vaginal lubrication, a lack of control in vaginal muscles, and a decreased ability to orgasm.  For men it can cause problems with erection and ejaculation. 

Okay before you get too depressed reading this I do want to say here and now that there are some things you can do about all this.  I cannot promise you that there is a magic wand to make things all better but there are definitely things one can do to increasing the chances for having better sexual relations despite having this illness.

I am going to be speaking from a woman's point of view here since...well...I am a woman.  I am hoping that a subsequent article might be written from a man's point of view about how to cope with the effect that MS may have upon one's sex life.  Any volunteers?