To describe sexual dysfunction (SD) in persons with MS, its impact on quality of life and relationship with bladder function. Persons with definite MS (n = 73) from a tertiary hospital database, interviewed using standardized measures. For disability: Neurological Disability Scale (NDS), American Urological Association Index, Urogenital Distress Inventory (UDI6), Incontinence Impact Questionnaire (IIQ7) and Personal Experiences Questionnaire (PEQ); participation: Multiple Sclerosis Impact Scale (MSIS). Mean age 50 years, 73% female, 52% progressive MS and 60% with detrusor overactivity. Fifty-one (72%) had PEQ scores indicating SD. Women reported greater SD than men (p = .013). SD included: lack of enjoyment of sexual activity (32%), failure of arousal (30%) and anorgasmia (47%). Patients who reported MS impacted 'a great deal 'on their sex lives, compared with those who did not, showed significant differences on PEQ Sexual Frequency (p = .01), IIQ7 (p = .03), UDI6 (p = .04) and both MSIS subscales (Physical p = .04; Psychological p = .03). The PEQ Sexual Frequency scale significantly correlated with NDS (rho = -.30), QoL Bladder score (rho = -.35) and MSIS Physical subscale (rho = -.30). No association was found between SD and age, years since diagnosis, stage or severity of MS. SD is complex and often overlooked in clinical care. Improved management options for SD may improve QoL in these persons.