Multiple Sclerosis and Men’s Sexual · PDF fileMultiple Sclerosis and ......
Transcript of Multiple Sclerosis and Men’s Sexual · PDF fileMultiple Sclerosis and ......
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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