How does PD Affect Sexual Health?
What are the facts about sexual dysfunction?
- Sexual dysfunction in PD is common, affecting men more often than women.
- It remains under appreciated as patients, spouses and health care providers may not be comfortable with a frank discussion of sex.
- Many factors contribute to good sexual health and it stands to reason that the combination of aging, general physical decline associated with PD, and other medical conditions will undermine sexual interest and performance.
- In PD, sexual dysfunction may arise as a primary symptom. In addition, physical immobility in bed, sleep disturbances, depression and disturbances in thinking can impact sexual desire in men and women.
- PD itself may cause sexual dysfunction as a result of the loss of dopamine, the principal neurochemical mediator of reward and pleasure in the brain.
- Sexual health should be as much a part of the conversation between the person with PD and his or her health care team as any other health matter.
- Various medications, including antihistamines, antidepressants, benzodiazepines, and drugs for high blood pressure and excessive alcohol or tobacco use can also contribute to sexual dysfunction.
- Fortunately, most anti-PD drugs are not associated with impotency or loss of libido, with the exception of the anticholinergics.
To the contrary, the dopamine agonists have been associated with disorders of impulse control such as:
- Uncontrolled gambling
- Uncontrolled shopping
- Uncontrolled eating,
- Obsessive compulsive tendencies such as cleaning and organizing
- Patients with PD who are taking dopamine agonists and have developed hypersexualty should discuss it with their neurologist. Usually decreasing the dose or complete discontinuation of dopamine agonists resolves the problems of impulse control.
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Medical content reviewed by: Nina Browner, MD—Medical Director of the NPF Center of Excellence at the University of North Carolina at Chapel Hill in North Carolina and by Fernando Pagan, MD—Medical Director of the NPF Center of Excellence at Georgetown University Hospital in Washington, D.C.