Sexual dysfunction in women

How does NMO affect sexual function in women?  

Female sexual function – like male sexual response – depends on good spinal cord connections and undamaged nerve pathways between the brain and the base of the spinal cord.

The types of problems that can occur include: decreased vaginal lubrication; loss of libido or sex drive; loss of vaginal muscle tone; reduced or painfully heightened sensation in the vaginal and/or clitoral area; and loss of ability to achieve orgasm.

Unfortunately, there are currently no specific medications available to treat these symptoms, but there are a variety of strategies that can help to minimise their impact. If you are referred to a specialist sex clinic, a sex therapist may be able to prescribe treatments that are not routinely available, depending on your particular circumstances.

In November 2009, the results of a clinical trial on a drug called flibanserin were presented at a scientific conference. The reported results suggested flibanserin might benefit women with low libido. However, it has not yet been licensed for use.

 

How can decreased vaginal lubrication be managed?

Vaginal lubrication is the aspect of female sexual response that corresponds most closely to erection in men, and there are ways of treating decreased vaginal lubrication. Some women find water-soluble lubricants like KY-Jelly, Sensilube, Replens or Astroglide help with lubrication. These lubricants are available over the counter and don’t be afraid to use lots of them. A small research study on women with MS has found that Viagra helps with lubrication, but has no significant effect on orgasm. However, because of its limited effect it is not currently prescribed for women.

 

How can loss of orgasmic capacity be managed?

The main complaint of women with NMO is loss of orgasmic capacity. There is currently no medications available to treat orgasmic loss, although research continues. In the meantime, vibrating stimulators may help as some women find they can still reach orgasm, but it takes longer, and requires more stimulation. Most women achieve orgasm through direct stimulation of the clitoris. This stimulation increases the blood supply to the clitoris causing it to enlarge and stimulate the vagina to produce lubrication. This is why women often say the most effective vibrators are those that include an externally vibratory feature.

 

Changes in sex drive

NMO can affect sexual desire (libido) and this is one of the most common sexual problems among women with NMO. If you don’t feel aroused it can be difficult to initiate sexual activity. But, even when people’s libido is low, the nervous system is frequently sufficiently intact for physical and emotional pleasure to be gained from sexual activity. There are various techniques available to help initiate sexual activity in such situations, including body mapping.

When considering what may have an influence on your libido, it is also important to look at factors not related to NMO. For example, sexual desire and activity generally fluctuate throughout life and many people report changes as they age. Other things in life, such as having children or menopause, may also have an influence. Emotional relationships can also affect sex drive. Anger or resentment in particular, whether NMO related or not, can affect the desire for sexual activity in both partners. 

 

If you have any tips that you have found beneficial, please let us know as it may help others nmo.advice@thewaltoncentre.nhs.uk