A loss of sensation in the genital area can pose problems for both men and women with MS. Fortunately, such a loss of sensation in most patients is usually temporary. In men, the use of Viagra and the other drugs in this group can, in part, overcome erectile dysfunction related to decreased sensation in some cases. Temporary or not, for many women, the use of vibrators can overcome the inability to achieve orgasm. Eros is a specially designed commercially available device to enhance clitoral engorgement and provide stimulation for women who require it. It is important that women consult physicians who are knowledgeable in this area. Generally, gynecologists and sex therapists are better informed than most physicians.
Clitoral engorgement blood flow to the female sexual organ, the clitoris, is associated with sexual excitement and results in clitoral enlargement (engorgement), and ultimately improves arousal and orgasm (sexual climax) in women. Gynecologists physicians who specialize in diseases that uniquely affect women.
Semen the fluid portion of the ejaculate consisting of secretions from the seminal vesicles, prostate gland, and several other glands in the male reproductive tract. Semen may also refer to the entire ejaculate, including the sperm.
65. How can I get my wife pregnant if I am impotent?
Clinics dealing with spinal cord injuries, such as VA hospitals, are able to help with this problem. By using techniques that are similar to those used in animal husbandry, semen can be harvested for successful use in artificial insemination. Personnel in spinal cord units at VA hospitals and universities should be contacted for help in this regard.
66. Can pregnancy bring on MS? What are the chances of an attack during pregnancy? Is it true that attacks are more severe after delivery?
Generally, women with MS feel better during pregnancy and have less likelihood of exacerbations of illness. Recent observations reveal that during the first trimester of pregnancy, the rate of attacks may be slightly increased, but during the second trimester, there is a marked lowering of the risk of attack. However, the third trimester is associated with a rising risk of exacerbation. In the 3 months after delivery, the risk is also high. A large French study showed that after delivery of the baby, the risk was increased by a factor of three for the first 3 months postpartum. Unexpectedly, the risk of exacerbations falls somewhat to a twofold risk for the next 33 months.
Earlier smaller studies in Minnesota had revealed an increased propensity to have exacerbations following pregnancy, whether or not the pregnancy went to term (lasted a full 9 months). In other words, termination of the pregnancy does not prevent the likelihood of increased risk of exacerbation and worsened illness.
In summary, the chances of an MS attack during the first trimester of pregnancy are only slightly increased and fall substantially during the second trimester. However, there is an approximately 30% increased likelihood of an exacerbation in the third trimester of pregnancy and a marked increase in the 3 months after delivery. The numbers translate roughly into a 70% chance of exacerbation occurring in the 3-month post delivery period.
Attacks postpartum tend to be more severe than average, but as at other times, the majority of MS attacks are not disabling. Treatment certainly can shorten attacks. The advent of the new and more rapidly effective treatment, natalizumab (Tysabri formerly referred to as Antegren), held the promise of reducing this risk, but this drug has, at least temporarily, been withdrawn from the market. The full effect of natalizumab in preventing attacks of MS is seen within 6 weeks after receiving the first dose. If this drug becomes available, it should not be given to the mother who is breast feeding because of its presence in breast milk; its possible impact on the child has not been studied.
I have had many miscarriages and have no children. Before I was diagnosed with MS, I thought I felt good during pregnancy because of emotions ofjoy and anticipation, and badly after a miscarriage, again because of emotions, albeit ones of grief and loss. Although emotions certainly played a part, I now understand that, as is often the case with MS, I had flare-ups after pregnancy.
Currently, I take estrogen replacement therapy. I am fortunate to have an endocrinologist who is intelligent and who listens to patients. When I began HRT, he informed me about the many estrogens and progesterones. Finding a balance was trial and error—error meant pimples and a desire to murder. The mere mention of the name of one estrogen still strikes terror in my husband!
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