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People who live with myasthenia gravis (MG) have muscle weakness and are more likely to report sexual problems than people without myasthenia gravis. In one study study published in the Journal of Neuroimmunology, more than 42 percent of male participants with myasthenia gravis reported erectile dysfunction, while nearly 50 percent of female participants reported sexual problems.
Because intimacy requires both physical stamina and emotional vulnerability, navigating a chronic neuromuscular condition like myasthenia gravis can introduce unexpected hurdles into the bedroom. Research hasn’t proven that sexual problems are caused directly by myasthenia gravis. Some sexual problems may instead be related to medications used to treat myasthenia gravis.
We’ll cover how common sexual dysfunction is with myasthenia gravis, what might be causing it, and what you can do to help improve these symptoms.
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According to Rare Disease Advisor, one sexual problem men with myasthenia gravis report is erectile dysfunction, which means difficulty getting or keeping an erection. Other forms of sexual dysfunction that affect people of any gender can include:
Sexual issues may also include difficulty with vaginal lubrication or orgasm. These changes can be frustrating, but recognizing them may help you find ways to adapt.
A few members on MGteam have talked about experiencing different types of sexual dysfunction. One shared, “Orgasms haven’t been the same for a while — less intense, like my pelvic floor went on strike.” Another said, “The libido? Low. The energy? Sporadic. The confidence? Somewhere under a heating pad.”
Myasthenia gravis specialists don’t know exactly what leads to these sexual problems. As noted above, researchers haven’t established whether myasthenia gravis itself directly causes sexual problems.
However, living with a chronic illness can take its toll on sexual function. Myasthenia gravis can change how your body looks and feels. That could change how you feel about sexual activity.
If you’re experiencing muscle weakness, you may not be as interested in or able to have sex or other intimate contact. Each person will experience symptoms differently, so this may not happen for everyone living with myasthenia gravis.
Some medications used to treat myasthenia gravis may cause sexual problems as side effects.
Corticosteroid (steroid) medications such as prednisone can suppress the immune system and cause weight gain, mood swings, lower testosterone levels in men, and lower libido. All of these may influence how you feel about your sex life in different ways.
Low testosterone, which may be connected to myasthenia gravis or its treatment, can lead to a low sex drive and erectile dysfunction. Gaining weight may cause you to feel differently about your body or lower your self-esteem, making it harder to feel confident about sex. Mood swings can make it harder to connect with your partner.
Other medications, such as mycophenolate and pyridostigmine (Mestinon), may also cause mood swings. Erectile dysfunction is another possible side effect of mycophenolate.
Never stop taking your medications or change your dose without talking to your neurologist or another healthcare provider first. If you’re having bothersome side effects, your doctor can help you figure out how to change your treatment plan so you feel better and myasthenia gravis stays under control.
Myasthenia gravis may impact your mental health, and this can lead to sexual problems, too. Myasthenia gravis is connected to both anxiety and depression, which can in turn interfere with sexual health. In fact, somewhere between 30 percent and 70 percent of people diagnosed with depression will experience sexual problems.
Researchers don’t know exactly how mental health issues connect to sexual problems. They may happen due to changes in neurotransmitter levels or changes in your relationships and how you feel about them. Specific mental health symptoms like fatigue, distraction, intrusive thoughts, or fear may also play a role.
Anxiety and depression are treatable, and getting help may improve both your mood and your intimacy.
If you’re experiencing sexual problems, you may feel isolated. However, you’re not alone. The study findings above suggest that many people living with myasthenia gravis experience similar symptoms.
Physical touch and intimacy are important parts of quality of life for many people. Fortunately, there are some steps you can take that might help you meet these needs while you’re living with myasthenia gravis.
You and your partner can define what sex and intimacy mean to your relationship. If sexual problems make it hard to have intercourse or achieve orgasm, consider finding intimacy together in other ways. Giving or receiving a massage or cuddling while watching a movie can maintain intimacy and protect your emotional bond without the pressure to have sex or use too much energy.
As one MGteam member put it, “Make everything about foreplay and don’t worry about duration. Desire is always there, physical ability rarely lets me. I’m just a cuddler anymore.”
Another wrote, “Maybe your legs aren’t always as strong, or your arms, but you can still make it work. Good luck, don’t worry that it’s not the same as when you were stronger. Hugs, kisses, and intimacy with your mate keeps you both happy!”
Some people find that trying different sex positions helps them stay more comfortable. You may need to try a number of positions before you find one that works for both you and your partner.
“Just don’t try to do positions that will impact how you function when it’s over,” said a member. “My advice: Enjoy it and stay safe.”
While spontaneous intimacy can be fun, planning ahead may have better results. Plan for sex during the part of the day when you have the most energy and the fewest symptoms.
If heat triggers your symptoms, you may want to keep the room cool or have sex during a cooler part of the day.
You could also plan activities that engage other senses, like smell or taste, to enhance the encounter. Consider other types of intimate touching, in case sex itself doesn’t work out.
Having a plan can give you confidence and help you feel ready for whatever sex and intimacy mean for you.
It can be hard to talk about how your myasthenia gravis symptoms affect your sex life with your partner. However, doing so may bring you closer rather than letting unspoken issues keep you apart. It may help to start the conversation at a neutral time, when you’re not in bed.
When you have the conversation, use “I” statements rather than “you” statements to avoid making your partner feel like they’re doing something wrong. Start sentences with “I” and focus on your own feelings and experiences. Focusing on “you” can sound like you’re blaming the other person.
Finally, come up with a way to invite your partner and signal that you’re interested in sex. This can be something silly, a code word, or a subtle way to say, “I’m ready.” This helps avoid confusion and makes it more likely that you can be clear with each other about when it feels like a good time to be intimate.
It may feel awkward to bring up sexual dysfunction with your myasthenia gravis specialist, but they can likely help you find solutions. Your quality of life is important, and a healthy sex life and regular intimacy are part of that.
Whether sexual problems are related to myasthenia gravis symptoms, side effects of treatment, or related conditions like depression, your doctor should be able to recommend changes that can help or refer you to another healthcare provider who can.
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