MS – Erectile Dysfunction Treatment — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

EasyMultiple Sclerosis & CNS InflammationMS – Erectile Dysfunction TreatmentSCE Neurology

A 50-year-old man with MS develops erectile dysfunction. He has no diabetes, cardiovascular disease, or hypertensive medications. He is on no DMT with urological or sexual side effects. What is the recommended first-line treatment for erectile dysfunction in MS?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Phosphodiesterase-5 inhibitor (e.g. sildenafil)

Erectile dysfunction is a common non-motor symptom in MS, caused by spinal cord demyelination affecting autonomic pathways. NICE NG100 recommends PDE-5 inhibitors (sildenafil, tadalafil) as first-line treatment for erectile dysfunction in MS, after excluding other causes (hormonal, vascular, psychological, drug-related). They are effective in approximately 70–80% of MS patients with ED. A: Intracavernosal injection is second-line if PDE-5 inhibitors fail. C: Testosterone replacement is only indicated if testosterone is low. D: Vacuum devices are an alternative. E: Prosthesis is last resort.

Reference: NICE NG100 MS (2022); NICE CG76 Sexual Dysfunction in Men