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Multiple Sclerosis and

Men’s Sexual Health

Douglas A. Woo, MD

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Douglas A. Woo, MD

• Medical College of Wisconsin

(MCW), graduated 2001.

• Neurology Residency training at

MCW, graduated 2005.

• Multiple Sclerosis Fellowship at

UTSouthwestern-Dallas, 2006. 2

Two Parts to the Topic

a. Pathophysiology and treatment of

Sexual Dysfunction

b. Relationship Health

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Talking to Your Physician About Sexual Health

• Only 5 to 15% of physicians proactively ask

patients about sexual function.

• Use neutral terms instead of colloquial terms:

“Achieving erection” instead of “Getting hard”.

“Achieving Orgasm” instead of “Coming”.

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Sexual Dysfunction in Multiple Sclerosis

• Affects up to 91% of males

• Cessation of sexual activity in up to 64%

1. Diminished libido

2. Difficulty achieving erection

3. Difficulty achieving orgasm

4. Pain with orgasm

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Activation of Brain Regions (e.g. arousal, fantasy)

precedes Penile Erection

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Nerve Impulses travel back and

forth through the SPINAL CORD

from the BRAIN to the

GENITALIA to induce the

Orgasmic Cascade.

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Decreased Libido may arise from:

• Fatigue

• Chronic pain

• Medication side effects

• Depression

• Testosterone deficiency

• Lesions in the arousal

centers of the brain.

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Difficulties with Erection or

Orgasm may arise from:

• Spinal Cord damage

Sexual Dysfunction is

highly associated with

Bowel and Bladder

dysfunction:

• Constipation

• Loose Stool

• Urgency

• Incontinence

• Retention

• Hesitency

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Nerve Stimulation

Treatments

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Phosphodiesterase Inhibitors:

Improve blood supply to the corpus

cavernosa.

Side effects: sudden hearing loss

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Treatments

Vibratory Stimulation (penile attachments)

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Treatments

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Vacuum Therapy

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Treatments

Penile Implant

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Relationship Health

• Multiple Sclerosis frequently places significant

strain on relationships with significant others.

• Up to 67% of marriages end in divorce after 24 yrs.

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The Five Love Languages

• Everyone has an “emotional tank”

• Relationships are partially dependent on each partner’s emotional tank

being filled.

• Your tank is filled when you receive affection from your partner.

• Your partner’s tank is filled when you give affection to your partner.

• Relationships become strained when the methods of giving and

receiving affection do not coincide.

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Up to 4 different Love Languages could be involved in a relationship:

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Partner A likes to:

• Give Affection with Language A

• Receive Affection with Language B

Partner B likes to:

• Give Affection with Language C

• Receive Affection with Language D

Up to 4 different Love Languages could be involved in a relationship:

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Partner A likes to:

• Give Affection with Language A

• Receive Affection with Language B

Partner B likes to:

• Give Affection with Language C

• Receive Affection with Language D

Up to 4 different Love Languages could be involved in a relationship:

Relationships can break

down if the Love Languages

don’t coincide.

25 http://www.polyu.edu.hk/sao/publications/emagazine/issue133/love%20language2.pdf

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The End

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