Sexual Side Effects of Parkinson’s Disease

By Patrick McNamara, PhD

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.¹

Parkinson’s and Male Sex Drive

Men with Parkinson’s disease may experience difficulty obtaining/maintaining an erection or ejaculating during sexual intercourse.¹

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.²

Other common disorders related to aging, like diabetes, hypertension, and high cholesterol, can also contribute to erectile dysfunction.³

Sildenafil can sometimes help with erectile dysfunction. Testosterone replacement therapy may also help with both erections and desire.¹

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.¹

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.⁴

An added benefit is that such therapy can help keep bones strong and flexible.⁴ Never, however, take any hormonal supplements without consulting with your healthcare provider 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.¹

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 healthcare provider 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.¹

Never stop any medication, or lower your dose, without your healthcare provider’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 healthcare provider about what you are experiencing. Remember that these issues are not uncommon in people with Parkinson’s and your practitioner is there to help.

In particular, see your healthcare provider 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 healthcare provider about hormone replacement therapy, and so forth.²
• Review your medications. Sometimes the root problem is the dose of PD medication you are on.² Consult with your PD practitioner 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.⁵
• 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.⁶ 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.

By Patrick McNamara, PhD
Patrick McNamara, PhD, is an associate professor of neurology and the director of the Evolutionary Neurobehavior Laboratory.

Video: “Rehabilitation of the patients with Parkinson’s Disease”

Set of exercises 1 for Parkinson’s Disease: improving joint mobility and increasing body flexibility

For additional information about Rehabilitation of the patients with Parkinson’s Disease you can watch a video demonstrating exercises and rehabilitation recommendations.

physiotherapy and rehabilitation

Rehabilitation methods for Parkinson’s disease, prescribed by a qualified specialist in physiotherapy and rehabilitation, combined with drug therapy, can significantly improve the quality of life of patients, improve motor and cognitive functions, and reduce the symptoms of the disease.

To maintain the health of patients with Parkinson’s disease, it is important to combine different operations and activities. Every day, you can combine and vary as follows – strength training, walking training, exercise bike training, training to improve joint flexibility, improve posture and balance. Of course, it is important to combine training with daily activities and, therefore, to practice the functions used in everyday life: sitting, getting up (from bed, from a chair), mobility in bed, etc.

The process of rehabilitation and treatment of patients with Parkinson’s disease, of course, depends on the disease stage (primary or progressive). But regardless of this, the process of developing and forming a rehabilitation program should take into account four main areas:

1. Improve joint mobility and increase body flexibility

2. Strengthening the musculoskeletal and muscular system, endurance

3. Improving the coordination and “composition” of any movement – dividing it into components.

4. Improve balance, gait and fall prevention

As recent studies have shown, for patients with Parkinson’s disease, it is important to form a rehabilitation plan based on a stepwise, gradually changing training rhythm and increasing exercise difficulty. Constancy and monotony in the choice of physical activity and activity is not recommended.

Check out the demo version of our sets of exercises for Parkinson’s Disease on YouTube

Our website presents the following sets of exercises for the rehabilitation of the patients with Parkinson’s Disease:

1. SET OF EXERCISES №1 FOR PARKINSON’S DISEASE: IMPROVING JOINT MOBILITY AND INCREASING BODY FLEXIBILITY

2. SET OF EXERCISES №2 FOR PARKINSON’S DISEASE: STRENGTHENING OF THE MUSCULOSKELETAL AND MUSCULAR SYSTEM, ENDURANCE

3. A SET OF EXERCISES №3 FOR PARKINSON’S DISEASE: IMPROVING THE COORDINATION AND “COMPOSITION” OF MOVEMENT – DIVIDING IT INTO COMPONENTS

4. A SET OF EXERCISES №3 FOR PARKINSON’S DISEASE: IMPROVING THE COORDINATION AND “COMPOSITION” OF MOVEMENT – DIVIDING IT INTO COMPONENTS

FREQUENTLY ASKED QUESTIONS

• What are the side effects of Parkinson’s medication?

The side effects of Parkinson’s medication will differ by each type of drug. Levodopa can cause side effects such as nausea, fatigue, and orthostatic hypotension (drop in blood pressure after standing up). A different drug type known as dopamine agonists, which include Pramipexole (Mirapex) and Ropinirole (Requip), are more often associated with impulse control and hypersexuality.⁷

• Which Parkinson’s medication can cause hypersexuality?

Dopamine agonists (DA) are a type of Parkinson’s medication that can cause hypersexuality. The word hypersexuality refers to heightened sexual arousal, interest, and behavior than what a person had previously experienced, and causes enough trouble to disrupt a person’s life as well as the lives of those around them. Hypersexuality is considered a rare side effect of using DA for Parkinson’s treatment, representing only 3.5% of the total users.⁸

• What are the symptoms of Parkinson’s disease?

The symptoms of Parkinson’s disease can differ from one person to another, but many people experience tremors, slow movement, stiffness, less frequent blinking, dry skin that can cause flakiness on the scalp, difficulty sleeping, and apathy.

Sources

1. Bronner G, Vodušek DB. Management of sexual dysfunction in Parkinson’s disease. Ther Adv Neurol Disord. 2011;4(6):375-383. doi:10.1177/1756285611411504
2. American Parkinson Disease Association. Sexual effects.
3. Urology Care Foundation. What is erectile dysfunction?
4. International Osteoporosis Foundation. MHT & SERM.
5. Lamina S, Agbanusi E, Nwacha RC. Effects of aerobic exercise in the management of erectile dysfunction: a meta analysis study on randomized controlled trials. Ethiop J Health Sci. 2011 Nov;21(3):195-201
6. International Society for Sexual Medicine. Can cognitive behavioral therapy (CBT) help people with sexual dysfunction?
7. American Parkinson Disease Association (APDA). Medications for Parkinson’s.
8. Codling D, Shaw P, David A.S. Hypersexuality in Parkinson’s Disease: Systematic Review and Report of 7 New Cases. Movement Disorders Clinical Practice, 2015;2(2), 116–126. doi:10.1002/mdc3.12155