Intimacy & Relationships

Reviewed by: HU Medical Review Board | Last reviewed: September 2021

Studies have shown that the symptoms of neuromyelitis optica spectrum disorder (NMO) can greatly impair sexual function in those with NMO. Depression and anxiety, fatigue, and problems with movement and mobility are just a few reasons why sex and NMO can be challenging.1

Having NMO does not mean the end of your intimate relationships and sex life. You may need to change up your approach or routine and try new things. Building a strong relationship with yourself and your partner can have its hurdles. However, it is important to remember that there are things you can do to help, even when you may feel like some things are out of your control.

NMO-related problems

Damage caused by NMO can lead to impaired sexual function. Some of these problems include:1-3

  • Decreased or painfully heightened sensation
  • Difficulty maintaining or achieving erections
  • Problems with arousal
  • Difficulty achieving orgasms
  • Decreased vaginal lubrication
  • Muscle spasms
  • Changes in sex drive
  • Feelings of dependency

While it may seem hard or embarrassing to bring up, talk to your doctor if you are having sexual function problems. There are medicines, therapies, and techniques to help.

Dating and new relationships

Being single and navigating the dating scene can have its challenges. When you have a chronic disease like NMO, these challenges may seem impossible. You are not alone, and others have gone before you. There are some things to keep in mind when dating or starting a new relationship:4

Be honest

Honesty really is the best policy when it comes to talking to your partner or love interest about NMO. Starting your romantic relationship based on honesty sets a standard of an open and honest partnership. Conversations might be hard at first, but try to be upfront about your needs and potential challenges.

You are not defined by NMO

Everyone gets nervous when first dating someone. While being honest about your disease and needs sets the tone for an open relationship, you are not defined by NMO. Play up your best features! Focus on the positive, and your love interest will follow your lead.

Embrace the unknown

The unknowns and unpredictability of NMO can take their toll on your mental health. Understanding and embracing this might help you to know that some things cannot be predicted. Plan ahead for what you can, but embrace the idea that you cannot predict the course and outcome of the disease.
Love yourself first. You are worthy of the love and respect that you deserve. Seek out people and relationships that respect and honor you as the whole person you are – with or without NMO.

Intimacy does not always mean intercourse

Having an intimate relationship allows you to experience intimacy and pleasure beyond just intercourse. If your sexual relationship has changed, having an open and upfront conversation with your partner is best. Talk with your partner about what is working and what is not working, as well as limitations you may have due to your NMO symptoms.4

Try not to judge your partner or get offended by the words your partner says in love and trust. Talking openly with them can allow you both to be closer without intercourse.

Ways to enjoy sex when you have NMO

Listen to your body and the symptoms you are currently experiencing. In addition, these tips may be helpful:4,5

Manage your symptoms

You will be more inclined to enjoy your intimate partner and sexuality if your NMO symptoms are under control. Because of the unpredictability of NMO, this is not always easy. You cannot predict your NMO attacks, but you can establish a routine that might help you to control your symptoms and pain. Keeping track of how you feel and ways that help manage your symptoms might help you take control of some of your symptoms.

Do your best to stay active

Staying active helps to keep you feeling your best and can really improve your mood. You may have to find what activity works best for you to stay active. Certain exercises and activities may not be possible with NMO. Low-impact activities such as walking, swimming, or yoga may provide you with the exercise you need. Always remember to talk to your doctor about the best type of exercise for you.

Experiment with different positions

Depending on your symptoms and how you feel, you may need to experiment with different sexual positions with your partner. Pain and limited mobility may limit you from your routine, but new positions may be the fun and excitement you and your partner desire.

Set the mood

A warm bath, candles, music, and fragrance may help you set the mood for intimate relations and intercourse.

Be creative

Intimacy can mean many things. Touch and massage, toys, and other techniques and devices can help you and your partner enjoy a pleasurable and satisfying sexual relationship.

Starting and maintaining healthy and fulfilling intimate and sexual relationships is possible with NMO. The person who you choose to have a romantic relationship with will take your lead when it comes to your disease. It is ok to have days when you need rest or are feeling sad about your symptoms. Relationships have their ups and downs, and a chronic disease like NMO can create its own challenges. Lead by example of how you would like to be treated.4,5

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