This session examines sexual function (SexFS) in women with MS as compared to sexually active U.S. general population and the relationship between MS symptoms and SexFS. Paper surveys included the following PROMIS domains and items: interest in sex (interest), satisfaction with sex life (satisfaction), interference of pain and fatigue with sex (pain- & fatigue-interference), orgasm ability (orgasm), vaginal lubrication (lubrication), pain during sex, pain intensity and interference, and fatigue. M=50 represents the average for sexually active U.S. adults. Descriptives, t-tests, and regressions were used. Women with MS (n=479) were an average age of 60 years, 88% white, and 61% married. Participants who were sexually inactive in the past month (52%) reported more fatigue, pain interference, and pain intensity than sexually active women (all p<.05). Of those sexually active: 24% reported moderate to severe pain during sex; 15% reported pain and 22% reported fatigue interfered with sexual satisfaction quite a bit to very much. Satisfaction (M=47.6, SD=8.2), orgasm (M=45.4, SD=12.2), and lubrication (M=45.1, SD=10.1) scores were lower than U.S. population (all p<0.0001). After adjusting for depression, pain intensity was associated with lower interest (p=0.002). Pain during sex was negatively associated with satisfaction, orgasm, and lubrication, after controlling for pain intensity and depression (all p<.05). Fatigue was not a unique predictor of SexFS domains. Fatigue and pain contribute to less sexual activity and greater sexual difficulties in women aging with MS. More research is needed to better understand sexual function of women with MS and to develop interventions.