Parkinson's Disease and Your Sex Drive

As if you don’t have enough to deal with. When it comes to Parkinson’s disease (PD), diminished sexual function is practically inevitable. From lack of sexual desire to low libido to difficulties with orgasmic functioning, this chronic, progressive, neurological disease can impair your sexuality in one way or the other.

That’s not to say, however, that those afflicted with Parkinson’s can’t restore their sex lives when faced with such challenges. Individuals with this most common form of “Parkinsonism,” a term that refers to any condition that causes symptoms like those of PD, can reclaim their sex life. Couples can minimize any disruptions to their lovemaking in knowing how to effectively deal with the problems that can arise.

Physical Issues of Your Sex Drive
Parkinson’s affects one’s autonomic nervous system, which controls sexual response and functioning. Parkinson’s acts upon neurons in the brain’s substantia nigra, causing dopamine-producing nerve cells to die. Since dopamine is a chemical that transmits signals between parts of the brain that usually coordinate smooth muscle movement, this is critical to sexual function on two fronts.

First, this dopamine drop may result in a decreased sex drive and sexual interest. Second, the lower levels of dopamine that result are believed to cause one’s loss of balance, changes in walking pattern and posture, muscle rigidity, Bradykinesia (the slowing down of movement and spontaneous activity), and tremors when resting. The symptoms of Parkinson’s can also be seen in:

Impaired sexual coordination: In general, slowed movements, muscle tremors, and rigidity can intrude upon one’s lovemaking abilities. The physical pain that may accompany such can also make sex painful or uncomfortable. Often fatigued and unable to control body movements, the person with Parkinson’s may find pleasures diminished as they are forced to be more passive.

Erectile Dysfunction (ED): Since PD impacts the central nervous system, men with PD may find themselves unable to attain or maintain an erection, let alone ejaculate. Issues with blood circulation to the penis and pelvic muscles can further lend themselves to ED.

Vaginal dryness: Women with PD may experience inadequate lubrication, the result of which is painful sex, with bladder infections quite common.

Lack of climax: Between reduced sexual feeling and functioning, both sexes may not be able to attain orgasm, even when sexually active.

Hypersexuality: While occurring in less than 1 percent of Parkinson’s patients, a person may develop a compulsive sex drive from antiparkinsonian medications (levodopa combined with a dopamine agonist).

Psychological Issue: Depression and Sex
With diagnosis and decreased physical capacity, a person’s sense of self is disrupted with Parkinson’s. Parkinson’s itself can cause changes in the brain’s chemicals that impact one’s mood and well-being.Depression can affect up to 40 percent of those with Parkinson’s. This is important to realize since sexual disorders may be due to the depression that can come with Parkinson’s diagnosis more than by the actual disease itself. The antidepressant medications that may be administered can also result in sexual dysfunction.

Other emotional issues for those who have Parkinson’s, which may result in sexual difficulties, include: anger, stress, grief, and mental fatigue. An individual grappling with Parkinson’s may experience reduced self-esteem, which can inhibit one’s sexuality. Such is made even more difficult by the body image problems that can arise, due to issues like changes in skin texture or the body smell that results from consuming Parkinson’s drugs.

The partner of a person with Parkinson’s can also have trouble coping with the situation. Issues that may arise include:

• Fatigue and resentment in taking on more responsibility.
• Dealing with their own feelings related to a partner’s diagnosis, like fear, anxiety, and depression.
• Loss of attraction and sexual interest due to the symptoms of PD, e.g., involuntary movements or changes in appearance, like the lack of facial expression.

Research in the Journal of Neurology, Neurosurgery and Psychiatry also found that the level of PD disability had a strong relationship to the healthier partner’s sexual functioning.

Relationship Issues
The physical and psychological challenges of Parkinson’s are in many ways inescapable, ultimately impacting a couple’s relationship. One 2000 study out of the Medical University of Lübeck in Germany found that patients with Parkinson’s were more dissatisfied with their sexual functioning and relationship than healthier counterparts. This is no surprise given that sexual dynamics are affected by matters like how each partner handles the Parkinson’s diagnosis, daily demands and lovers’ changing roles.

The relationship, including the sex, becomes unfamiliar in many ways, especially for couples who have been together long term. A 2000 study found that affectionate touching and the expression of feelings were reduced, despite both partners desiring intimacy. This may be in part due to couples often sleeping in separate beds since the Parkinson’s symptoms typically get worse at night. Such sleeping arrangements reduce the opportunity for spontaneous sexual contact.

Resolving Relationship Issues
The sexual and relationship complications that can arise with Parkinson’s can be devastating, with every couple’s experience different. Individuals and couples should seek guidance and support in reducing sexual consequences that can arise. Primary strategies include:

Discuss your medications: While many of the symptoms of Parkinson’s medication can be managed with medication, these drugs can decrease sexual desire, libido, and response. So you need to talk to your doctor about a treatment’s side effects. Your doctor can help you to decide upon the best course of action and suggest medications that can alleviate any sexual problems.

Erectile dysfunction, for example, can be reversed by treatment with dopaminergic drugs, which can increase sexual functioning since they mimic or heighten the effects of dopamine producing neurons. Viagra, an ED medication, has been found helpful over a two-month period, with significant improvements in overall sexual satisfaction, desire, ability to experience and maintain erection, and have orgasm. In considering medication treatments, be sure to discuss any contraindications with your doctor.

Communicate: Many relationship and sexual issues stem from partners avoiding the discussion of their concerns and fears. Lovers need to talk about what’s going on in processing the diagnosis, the symptoms, and how this is affecting their sexual intimacy. If necessary, seek out a sex counselor to facilitate communication.

Furthermore, couples need to exemplify their support to one another verbally, e.g., give each other compliments to maintain or boost one’s self-esteem and desirability.

Take on fatigue: With Parkinson’s symptoms typically less pronounced in the morning, aim to make love early in the day. Exercising regularly can also reduce fatigue in bolstering stamina and fitness. So be sure to consult your doctor on the best exercise activities for you.

Experiment: Couples must be willing to adapt their sexual patterns, attitudes, and habits, lest they face more problems. This may involve using lubrication, trying different forms of stimulation, and exploring new positions. Parkinson’s can provide you with the opportunity to redefine sexual intimacy – in many ways for the better. But only if you let it!

Article by Yvonne K. Fulbright, PhD, MS Ed.  Reprinted (posted) with permission from www.disaboom.com , a website that contains information and resources for people with disabilities.

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