Sexual Side Effects of Parkinson's Disease

Parkinson's disease causes sexual symptoms, some of which affect men and women differently. In addition, Parkinson's medications can cause side effects that affect sex drive; some drugs increase it while others decrease it.

Parkinson's and Male Sex Drive

Men with Parkinson’s disease may experience difficulty obtaining/maintaining an erection or ejaculating during sexual intercourse.

Abnormalities in the function of the autonomic system may be one contributing cause of erectile dysfunction in men with PD. Erectile dysfunction in Parkinson’s disease can also be directly related to the low dopamine levels of the brain.

Other common disorders related to aging, like diabetes, hypertension, and high cholesterol, can also contribute to erectile dysfunction.

Sildenafil can sometimes help with erectile dysfunction. Testosterone replacement therapy may also help with both erections and desire.

Parkinson's and Female Sex Drive

Common sexual issues in women with Parkinson's disease include loss of lubrication and involuntary urination during sex. Sex can be uncomfortable because of a lack of lubrication and desire.

For women with PD who have experienced menopause, the decline in sexual interest may be due to both menopause and PD. Hormone replacement therapy may help the physical effects of menopause.

An added benefit is that such therapy can help keep bones strong and flexible. Never, however, take any hormonal supplements without consulting with your doctor first.

Sexual Effects of Parkinson’s Medications

Sometimes persons with PD can experience a dramatic increase in sexual interest and activity. When dosages on some PD medications are too high it sometimes becomes more difficult for some people to control their impulses.

These impulse control disorders may involve things like excessive spending and gambling, but also too much interest in sexual activity. It is very important for people with PD to be aware of this and to have their doctor adjust their medications at the first signs of these issues.

The medications most often related to impulse control problems are the dopamine agonists rather than levodopa, per se. The good news is that impulse control problems appear to be 'dose-dependent, meaning that the unwanted behaviors go away when you reduce how much of the drug you are taking.

Never stop any medication, or lower your dose, without your doctor's OK.

Strategies to Improve Your Sexual Health

These challenges can naturally make anyone with PD concerned. Your first step should be speaking openly and honestly with your doctor about what you are experiencing. Remember that these issues are not uncommon in people with Parkinson's and your doctor is there to help.

In particular, see your doctor to:

• Identify the root cause(s) of the problem. If it is related to depression, treat the depression; if it is related to a reduction in sex hormones, ask your doctor about hormone replacement therapy, and so forth.
• Review your medications. Sometimes the root problem is the dose of PD medication you are on. Consult with your PD doctor about adjusting the dose.

You can also take steps that may be helpful on your own:

• Engage in vigorous exercise whenever you can as it will improve physical stamina, libido, and mobility.
• Seek out physical therapy to improve mobility.
• Try cognitive-behavioral therapy and psychotherapy, which may help you talk through worries, fears, and feelings of loss. Getting beyond these negative feelings may allow you to more fully enjoy the moment with your partner.
• Consider taking a massage class with your partner to find new ways to maintain intimacy while you are struggling with sexual dysfunction.
• Talk with your partner about what you are going through. Understanding starts with open dialogue.