MSA Trust


Having a diagnosis of MSA does not mean all possible symptoms will be experienced. Symptoms can change over time and progression will be individual.

There is currently no cure or specific treatment to prevent MSA progressing but there are ways of helping to manage your symptoms.

We are here to support people at every stage of your diagnosis, along with your family, friends, carers and healthcare professionals.

What are the first signs of MSA?

For men, the first symptom is often erectile dysfunction (the inability to achieve or sustain an erection). The problem is often incorrectly attributed to ageing or stress related issues without exploring other possibilities.

Bladder issues may also be evident. These can be:

  • urgency (needing to rush to the toilet)
  • frequency (needing to go often)
  • nocturia (night time passing of urine)
  • retention (not being able to pass urine).

All of these can change over time. People often don’t seek advice from their GP as they believe ageing or other problems such as prostate or pelvic floor weakness may be the cause.

Other problems can include feeling stiff and slow movement as well as changes in handwriting. Some people become clumsy or unsteady when walking. If blood pressure control has been affected then people may feel dizzy when standing up or experience episodes of fainting.

Many people are diagnosed with Parkinson’s Disease initially; this doesn’t mean your Neurologist has got the diagnosis wrong. MSA can look like Parkinson’s Disease in the early stages and often it isn’t until later when other symptoms develop, or the progression of symptoms is faster than expected, that the diagnosis is revisited.

There are three groups of symptoms which reflect the three main areas of the brain that may be involved:

  • the basal ganglia causing problems with movement (parkinsonism)
  • the cerebellum causing poor balance and co-ordination
  • the brain stem causing autonomic problems such as poor bladder and blood pressure control.
Basal ganglia causing problems with movement (parkinsonism)

Feeling slow and stiff when moving

Difficulty in starting to move

Difficulty turning in bed

The cerebellum causing poor balance and co-ordination

Feeling clumsy and dropping things

Finding it difficult to fasten buttons or zips

Feeling unsteady in crowds

Unable to balance without support

Difficulty writing

Slurred speech

Brain stem causing autonomic problems such as poor bladder and blood pressure control

Bladder problems

Feeling dizzy or fainting (blood pressure problems)

Pain around neck and shoulders (known as ‘coat hanger pain’)


Cold hands and feet

Problems with temperature control

Excessive sweating

For men, difficulty with erection

Other problems

Weakness of arms and legs

Unpredictable emotional response, laughing or crying

Restless sleep


Noisy breathing during the day and excessive snoring at night (known as ‘stridor’)

Unintentional sighing

Weak, quiet voice

Swallowing problems, difficulty chewing, choking episodes

Eye muscle weakness which may cause blurred vision

Having a diagnosis of MSA does not mean you will experience all of these symptoms.

There is currently no specific treatment to prevent MSA from progressing (although clinical trials and research are being undertaken) but there are ways of assisting and alleviating symptoms. These include lifestyle adaptations, medications for specific symptoms and ensuring you get the support and advice from the professionals involved in your care.

Remember the MSA Trust is here to help.

What happens next?

MSA is degenerative, which means that unfortunately symptoms are likely to worsen over a period of time. Over time the need to rely on others for help may arise. The speed of these changes is difficult to predict as people with MSA experience it differently and the speed of progression varies from person to person.

Some people feel they cope better if they know what lies ahead. Whilst MSA progression is very individual and unpredictable, you can discuss what might happen in the future with your specialist or our MSA Health Care Specialists.


We have taken every care to ensure the accuracy of the information contained on this webpage. It is produced independently, is not influenced by sponsors and is free from endorsement. The information should not be used as a substitute for the advice of appropriately qualified professionals, if in any doubt please seek advice from your doctor or legal professional.
References for this information are available by contacting

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