How to Cope with Sexual Side Effects of Parkinson's Disease

Along with the general sexual symptoms, Parkinson's disease can cause, it can also affect men and women differently. In addition, medication can cause side effects that affect sex drive (some drugs increase sex drive while others decrease it). Let's take a look at these issues and how to cope with them:

Parkinson's Effect on Men and Sex Drive

Men with Parkinson’s disease may experience difficulty obtaining or maintaining an erection 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.

Women and PD

Not much is known about PD's impact on women, but what is known is that women with Parkinson’s disease often experience a decline in sexual desire and a reduced ability to experience orgasm 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 women. An added side benefit is that such therapy sometimes helps to 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 include too much spending, too much gambling and too much interest in sexual activity. It is very important for persons with PD to be aware that impulse control problems can sometimes occur when taking PD medications. At first signs of these issues, you should have your doctor adjust your medications. You do not want to spend your family’s savings on impulsive spending sprees, gambling junkets, or sexual improprieties. 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 the dose.

Ways to Circumvent What PD Throws at You

Many questions crowd into the consciousness of an individual who has been diagnosed with PD—among them are questions about sex and your partner. Can I adequately satisfy the needs of this person I love? If I cannot correct this problem what will happen to our relationship?

There are steps you can take to help alleviate your worries.

• Identify root causes 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.
• Sometimes the root problem is the dose of PD medication you are on. Consult with your PD doctor about adjusting the dose.
• Engage in vigorous exercise whenever you can as it will improve physical stamina and mobility. It will also enhance hormone levels in some people.
• Participate in a series of physical therapy treatments as these improve mobility.
• Cognitive-behavioral therapy and psychotherapy may help to talk through worries, fears, and feelings of loss. Getting beyond these negative feeling may allow you to more fully enjoy the moment with your partner.

• You and your partner might consider taking a massage class together to find new ways to maintain intimacy while you are struggling with sexual dysfunction.
• Talking with your partner about what you are going through is usually a good idea as well.

_Source:

_{Waters C and Smolowitz, J. (2005). Impaired sexual function. In: Parkinsons Disease and Nonmotor Dysfunction. RF Pfeiffer and I. Bodis-Wollmer (Eds), Humana Press, Totowa, New Jersey, pps 127-138.}