The sexual satisfaction of women with multiple sclerosis (MS) improved when they actively sought out ways to deal with the practical challenges related to sexuality instead of just relying on managing their emotions, a study finds. It's therefore important for women with MS to consider a problem-focused coping strategy alongside managing their emotions to preserve sexual satisfaction and intimacy, said the researchers in “The relationship between coping strategies with sexual satisfaction and sexual intimacy in women with multiple sclerosis,” which was published in the Annals of General Psychiatry. Challenges with sex and intimacy are common with MS and the disease can impact sexual satisfaction. In women, MS can lead to a lower response to touch, trouble reaching orgasm, and vaginal dryness, which can make intercourse uncomfortable. Symptoms of MS, such as tiredness, muscle stiffness or spasms, and mood changes can make it harder to maintain intimacy and engage in sexual activities or enjoy them fully, leading a team of researchers in Iran wanted to understand how women with MS cope with these challenges and how the way they do it relates to sexual satisfaction and intimacy. Some coping strategies for meeting or adjusting to a stressful situation are more effective than others. In general, “the purpose of these strategies is to manage and change the source of stress (problem-focused strategies) or to regulate stressful emotions (emotion-focused strategies),” the researchers wrote. Having MS, having sex. To know which are used by women with MS, researchers asked 122 married women who were members of Iran’s MS society in Tehran to respond to the Folkman and Lazarus Coping Strategies Questionnaire and other sex-related questionnaires. The women were a mean age of 36.3 and had had the disease for a mean of 7.95 years. Most (82.8%) women had relapsing-remitting MS; 13 (10.6%) had primary progressive MS, and eight (6.6%) had secondary progressive MS. On average, the group had sexual intercourse 1.6 times a week after they received their diagnosis of MS, down from 1.93 times a week before the disease. Most (88.5%) women didn't receive sexual counseling. Their mean score on the Index of Sexual Satisfaction was 89.3 points, indicating moderate sexual satisfaction. On the Sexual Intimacy Questionnaire, their mean score was 80.5 points, indicating moderate sexual intimacy. More than half (58.2%) the women used emotion-focused coping strategies, meaning they tried to regulate their feelings about the challenges they faced. The most often used strategy was escape avoidance, that is, changing their behavior in order to avoid thinking about a stressful situation. The remaining 51 (41.8%) used problem-focused coping strategies, meaning they actively tried to find ways to deal with their challenges. The most often used strategy was positive reappraisal, which involves drawing on emotions to give value to a stressful situation in order to accept it. Sexual satisfaction was higher among women who used problem-focused coping strategies than among those who used emotion-focused coping strategies (95.6 vs. 84.7 points, respectively). Scoring higher than 90 points on the Index of Sexual Satisfaction indicates high sexual satisfaction. Using problem-focused coping strategies, having more frequent sexual intercourse, and being married for less time were linked to higher sexual satisfaction. Relying less on managing emotions and having more frequent sexual intercourse were linked to higher sexual intimacy. “The findings from this study indicated that there was a significant positive relationship between problem-focused coping strategies and sexual satisfaction,” the researchers wrote, adding healthcare providers who work with women with MS should “focus on improving women’s skills on using [a] problem-focused coping strategy."