The Impact Of ALS On Sex And Intimacy

Just as physical and mental health is important to us, our sexual health is also as vital to keeping our marriage with our partner strong and intact. Having normal sexual function is not only crucial for partners but also for one’s own self-worth as well. Although sexuality is often linked with the idea of only physical sex, it is actually more than that.


For individuals with Amyotrophic Lateral Sclerosis or ALS, sexuality has become one of the most common issues for them and their partners. They are mostly aware of what problems might emerge as the disease progresses, and so they strive to find ways to understand it better. This way, they are able to help each other alleviate the coming challenges that the ALS may pose in terms of sexuality and intimacy. Despite this, Dr. Holzberg, PhD., finds that “ALS indirectly affects sexuality, thus confirming the need for promoting awareness regarding sexuality-related topics among individuals with ALS and healthcare professionals. ALS multidisciplinary clinics need to improve their delivery of care to address sexual rehabilitation as a complementary therapy.”


Sex Life And ALS

  • Direct Effects

Respiratory: The disease has a direct effect on the individual’s respiratory function, therefore affecting his breathing significantly. Because of this, a more active and vigorous sexual activity may not be possible. Doctors have attempted to provide assistance in this area by recommending patients to utilize Non-invasive positive pressure ventilation or NIPPV, although the machine may provide unnecessary discomfort during intercourse.


Muscles and nerves: Sexual intercourse is the combined interaction of impulses coming from autonomic and sensory nerves, including involuntary muscle movement. Because ALS directly impacts the nerves that innervate the muscles for voluntary movement, these muscles have a lesser action during sexual intercourse. Nevertheless, they are not responsible for sexual sensation and satisfaction, and therefore have little effect on the outcome of sexual activity.

  • Indirect Effects

Aside from the respiratory abnormalities and muscle weakness, there are other symptoms that indirectly affect the sex life of an individual with ALS. Medications have shown to have a vital impact on this area. Physically, he is suffering from fatigue, sleep deprivation, muscle tightness and spasms, and has decreased ability to communicate spontaneously. These manifestations contribute to the changes in one’s ability to fulfill his usual sexual activities.


Self-image can also be crucially affected with the issue of sexuality. Most who suffer from ALS experience decreased self-esteem, anxiety, and depression. They are swallowed by feelings of negativity and insecurity due to the changes in sexual function and decreased intimacy between him and his partner. Once this happens, the help of a mental health professional must be sought.

  • Effects On The Partner

The decline in sexual desire in individuals with ALS doesn’t only affect them greatly but also has a significant impact on their partners psychologically. They feel stressed, afraid, and depressed, as they are often the primary caregivers of their afflicted partners. As these feelings pile up, they may also feel less excited to have sex with their partner. Most of them agree that the role of partner or spouse and caregiver is quite exhausting, that it sometimes leads them to feel resentment towards their partner.


Tackling Sex And Intimacy Issues

The first crucial step to dealing with sexuality issues is accepting and understanding them. You and your partner need to talk openly about these challenges. You must overcome the problem of not being comfortable discussing about sex, as this further hinders you from successfully dealing with it. Also, when you become uncomfortable with your partner, you become less and less intimate with each other.


Despite the difficulties, individuals with ALS should eventually learn to open up and share their fears and bad thoughts because this will, in turn, help their partner to better understand what they’re going through. Having each other and supporting one another will bring them closer and will go a long way in overcoming their fears.


What would be more helpful is to seek help from health care professionals, including your occupational and physical therapists who can provide possible treatments and modifications to lessen the discomfort. Seeing a psychiatrist or counselor will also help alleviate anxiety and depression.


Finding Ways To Make Sex Work

Dr. Liza Berdychevsky also highlighted the significance of sex in adulthood by emphasizing that “the many physical health and psychological benefits of sex may explain why preserving sexuality in older adulthood is considered to be an essential quality-of-later-life issue and an aspect of healthy aging.”

As the disease progresses, sexual intercourse issues will become more of a problem. It is therefore encouraged that couples seek guidance from experts on how to modify the sexual activity to fit their situation. Dr. Wasner, PhD., further suggests “counselling and information should be made available in order to better address this important aspect of quality of life.” You can try new positions that might decrease energy expenditure so as not to exhaust yourself too much. Talk to your lover about changing roles, like agreeing to be the submissive and her being dominant. It will perhaps make it more exciting and intimate for both of you.


Again, the importance of communication cannot be over-emphasized. Talk to each other before and after having sex. Tell each other what worked and what didn’t. Be there for each other. Face the physical and emotional challenges head-on. Don’t give up, and live as meaningfully as possible.

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