George Krucik, MD, MBA
Multiple sclerosis is a disease affecting the nervous system, specifically the central nervous system, which includes the brain and spinal cord. It is more common in young adults to middle-aged people and more frequently found in women than men. The immune system damages an area of the nervous system, causing symptoms. The area may then be repaired, decreasing the symptoms, and in time, a new lesion develops in the same area or elsewhere. Symptoms vary, depending on the area of the nervous system that is affected and the severity of the damage. Most symptoms in men are the same as in women.
Vision is controlled by a series of many nerves from the eye to the vision center of the brain. A multiple sclerosis lesion anywhere along the nerves responsible for vision can cause difficulty seeing. According to "Harrison's Principles of Internal Medicine," by Anthony Fauci, M.D., optic neuritis is one such lesion. It causes painful vision loss in one eye. Lesions of the nerves that control the movement of the eyes can cause double vision by impairing the ability of one or both eyes to focus on one point.
Weakness, Numbness and Coordination Problems
Multiple sclerosis can affect men anywhere along the brain and spinal cord. Nerves that control the function of the limbs may be affected by the lesions. According to "Current Diagnosis and Treatment in Neurology," by Dr. John Brust, this can cause weakness in the muscles responsible for moving the limb or limbs, as well as numbness. In addition, the deficits can cause coordination problems.
Pain and Tingling Sensations
If the lesions affect only sensory nerves, they will cause only sensory manifestations such as pain and tingling. This can occur with lesions in the brain or spinal cord.
Gastrointestinal and Urinary Problems
Gastrointestinal and urinary problems tend to be more prevalent with lesions affecting the spinal cord. The gastrointestinal and urinary tracts are largely controlled by autonomic, or automatic, nerves that coordinate their actions without a person's volition or awareness. When areas of the central nervous system controlling these functions are affected, it can cause symptoms such as diarrhea, constipation or urinary retention.
Sexual symptoms in men can occur from lesions typically located toward the bottom of the spinal cord. This can lead to difficulty with erections, orgasm or ejaculation. In addition, lesions in the brain can lead to a decreased interest in sex.
Cognitive and Emotional Symptoms
The disorder also can cause men to have emotional problems such as mood swings or depression. It can interfere with thinking and concentration and cause fatigue or lack of motivation.