Sexuality and intimacy are basic aspects of human life. Sexual desires and abilities may not be affected by the disease process, except for the physical limitations imposed by physical discomfort, muscle weakness, and fatigue or low energy levels. Anxiety may cause impotence. The person with ALS may worry about not being able to please a healthy partner.
Other factors that may contribute to unsatisfactory sexual relations are:
- Adjustment to assistive devices or support systems
- Dealing with everyday survival
- Decreasing self-image
- Grooming
- Level of communication
- Mobility
- Physical appearance
The following issues may also be of concern:
- Altered role
- Emotional state
- Functional level
- Mobility level
- Range of motion
- Self-care level
- Self-image
You and your partner may need counselling with an empathetic healthcare provider in order to deal openly with mutual concerns and expectations. If you are both willing, you could explore
different sexual behaviours, role flexibility, and alternative methods of sexual expression.
The following suggestions may prove helpful in dealing with sexual concerns:
- Using techniques, assistive devices, and positioning to accommodate increasing muscle weakness and other symptoms of ALS
- Identifying techniques and assistive devices that enable you to maintain good grooming and personal cleanliness
- Maintaining communication (the open expression of affection and need is important.)
- Respecting the boundaries of the other partner
- Altering the living environment to provide adequate privacy and reduce embarrassment
- Scheduling of “adult time” if there are young children in the family
- Wearing street clothes rather than night attire whenever possible during the day to stress normality
- Re-channelling interests and energies into other areas
Partners should realize that touching is as important as sexual performance in reducing tension and maintaining emotional intimacy. Preservation of personal integrity should be an overriding
concern. If you have any questions or concerns, speak with your doctor and request a referral to a sexual health clinician in your area.
Massage and Touch Therapies
Touch therapies can be very relaxing and comforting for people with ALS. They can warm up limbs, which often feel cold because of inactivity, low circulation and decreased muscle mass. Though touch therapies are usually given by a caregiver or therapist, self-massage can also be very beneficial.
The easiest touch therapy to learn is massage. For the most beneficial massage, body oil is used to lubricate the skin, which aids in soothing and relaxing the muscles. Massage involves systematically stroking, kneading and pressing the soft tissues of the body with fingers and the palm of the hand, working on the muscles, ligaments and tendons. A complete massage covers the entire body, inducing a state of warmth and relaxation. However a massage of parts of the body, such as arms, legs or shoulders is also beneficial and will help improve circulation.
Shiatsu
Shiatsu is a Japanese system of touch therapy and is given using fingers, thumbs and hands. The forearm, knees, and feet can also be used, applying pressure to specific points on the body.
Reflexology
Reflexology is based on the theory that pressing and massaging certain points in the feet will affect the whole body and induce relaxation.
Aromatherapy
Aromatherapy is a massage that involves the use of fragrant oils, which penetrate the skin, adding another sense of pleasure to relaxation.
Cranio-Sacral
A cranio-sacral massage is a very light and gentle massage of the back of the head and neck. It is non-invasive and very soothing.
Tens Machine
A Tens Machine stimulates muscles through electronic impulses, and is often used by physiotherapists.
Costs
The cost of most massage treatments ranges between $40 and $75 for sessions up to an hour in length. Most of these treatments are not covered by provincial healthcare plans, but may be covered in whole or in part by private or group insurance if they are prescribed and/or delivered by a registered therapist.
