Which of the following is NOT a known expression of primary sexual dysfunction in MS?

Sexual dysfunction in individuals with multiple sclerosis (MS) can manifest in a variety of ways, and understanding these expressions is crucial for effective management and patient support. The known expressions of primary sexual dysfunction typically include issues that directly affect sexual arousal and response, such as decreased libido, altered genital sensation, and the inability to reach orgasm.

Decreased libido refers to a reduction in sexual desire, which is a common complaint among individuals with MS, often resulting from a combination of physical and psychological factors. Altered genital sensation encompasses changes in feeling during sexual activity, which can significantly affect sexual satisfaction and performance. Inability to reach orgasm is another troubling aspect that affects sexual health, as it can create frustration and emotional distress.

On the other hand, difficulties in peripheral coordination do not directly relate to sexual function. While MS can affect coordination and motor skills, these symptoms are more associated with general physical mobility and control rather than specifically impacting sexual arousal or response. Therefore, identifying peripheral coordination difficulties as not being a direct expression of primary sexual dysfunction in MS highlights the importance of focusing on issues that directly influence sexual health and intimacy.