Gulnara Akhmadeeva

Sex with Parkinson’s Disease: Don’t Be Afraid to Live Fully!

Parkinson’s disease is a serious challenge that affects many aspects of a person’s life. However, research results PRIAMO, conducted by Italian scientists from the Center for Neurodegenerative Diseases CEMAND) University of Salerno provides an inspiring perspective on the importance of sexual activity for men with early stages of Parkinson’s disease. This data confirms: an active sex life can be an important tool in improving both motor and non-motor symptoms.

It turns out that sex can help improve the health of a person living with Parkinson’s disease. This conclusion was reached by the authors of a new two-year study that observed the sexual habits and disease progression among 355 patients at the Center for Neurodegenerative Diseases at the University of Salerno in Italy. Dr. Picillo and her colleagues concluded that sexually active male patients experience a “milder” progression of the disease and have less motor deficit, as well as report fewer other non-motor symptoms (compared to those who do not).

Parkinson’s disease can negatively affect a patient’s sex life in several ways.

  1. Parkinson’s disease often causes tremor and stiffness throughout the body. This can complicate the technical aspects of sex and make it difficult, painful, or uncomfortable.
  2. Men with Parkinson’s disease may experience erectile dysfunction (ED) due to nerve and muscle issues. ED can occur with impaired blood circulation in the genital area. This happens due to dysfunction of the autonomic nervous system in Parkinson’s disease (leading to arterial hypotension), as well as the use of antiparkinsonian medications (which in most cases can also lower blood pressure)
  3. Women with PD due to the same autonomic dysfunction may have insufficient moisture in intimate areas and often need additional lubrication.
  4. Both men and women may notice a decrease in libido (sexual desire) after being diagnosed. This may be related to a decrease in dopamine levels, the main causal neurotransmitter in Parkinson’s disease. Alternatively, it may be due to manifestations of anxiety-depressive disorder (this is also common in Parkinson’s disease)
  5. Furthermore, some medications, including antidepressants, can themselves reduce sexual desire.
  6. On the other hand, there is a group of drugs—dopamine receptor agonists (which include medications such as pramipexole, piribedil, ropinirole)—that can cause hypersexuality and excessive sexual desire, leading to deviant behavior. This is called impulsive-compulsive disorders, and if problems arise in the family, they need to be identified and controlled (primarily by changing the antiparkinsonian treatment regimen).
  7. And finally, of course, the stress from the seriousness of the situation can also affect the patient and their partner—sometimes fatigue and lack of sleep can reduce (or temporarily postpone) the desire for sex.

Why is sexual life important?

Sexual activity is not just an aspect of personal life but also an indicator of overall health. Research shows that men with Parkinson’s disease who maintain sexual activity experience slower disease progression, improved quality of life, and reduced symptoms of depression. This important finding highlights that intimate life can play a significant role in rehabilitation.

What does research say?

As part of the research PRIAMO scientists analyzed data from 355 patients with early-stage Parkinson’s disease over two years. At the beginning of the study, 56.3% of participants reported their sexual activity, and after two years, this figure decreased to 50.8%. Interestingly, men were twice as sexually active as women. However, almost half of the sexually active men faced erectile dysfunction and other difficulties in their intimate lives.

Positive Effects of Sexual Activity

The results of the study showed that men with an active sex life:

  • less frequently experienced apathy and gastrointestinal issues
  • had less pronounced movement disorders;
  • reported better quality of life and lower levels of depression
  • complained less about fatigue and attention problems;
  • observed slow progression of the disease

The most important thing is that these positive changes were observed regardless of the severity of the disease.

Why does it work?

Sexual activity can be considered a form of physical and emotional activity that positively affects the body. It helps maintain motivation, improves circulation, reduces stress levels, and promotes the production of happiness hormones. All of this can have a beneficial impact on the course of Parkinson’s disease.

What to do if there are difficulties?

If you or your partner are experiencing difficulties in your sexual life, it is important not to ignore the problem. Discuss it with your healthcare provider. Modern treatment methods, including medication and psychological support, can help address issues such as erectile dysfunction or decreased sexual desire.

The Importance of Open Dialogue

Scientists emphasize that doctors should actively inquire about the sexual life of their patients with Parkinson’s disease. This aspect should not be considered secondary—it can significantly affect overall health and quality of life.

Interview with a Parkinsonologist: Sex and Sexual Activity in Parkinson’s Disease

Interview with Neurologist-Parkinsonologist, PhD Gulnara Akhmedeeva about Sex in Parkinson’s Disease

Can sex improve the condition of patients with Parkinson’s disease?

Gulnara Akhmadeeva: Hello everyone! Today we are discussing a topic that might not be immediately addressed during a doctor’s appointment. It’s sex and sexual activity in Parkinson’s disease. It turns out that sex can improve motor activity in patients living with Parkinson’s disease. This conclusion was reached by Italian researchers who conducted a two-year study of 355 patients with the condition. They found that sexually active male patients experience milder disease progression, less motor deficit, and fewer non-motor symptoms compared to those who do not lead an active sexual life. Let’s explore how sexual activity can change depending on the course of Parkinson’s disease.

What physiological problems in sex can arise due to Parkinson’s disease?

Gulnara Akhmadeeva: In fact, there can be several such influences. Parkinson’s disease often causes tremor and stiffness, which can complicate the technical aspect of sex, making it painful, difficult, or uncomfortable. Men with Parkinson’s disease often experience erectile dysfunction related to impaired blood circulation in the genital area. This occurs due to disruptions in the autonomic nervous system and decreased blood pressure. It is also worth considering that many antiparkinsonian medications can lower blood pressure, further affecting sexual function.

What sexual problems do women with Parkinson’s disease face?

Gulnara Akhmadeeva: Women with Parkinson’s disease may also face issues such as insufficient moisture, requiring the use of additional lubrication. Both men and women may notice a decrease in libido after diagnosis. This is related to a decrease in dopamine levels, a key neurotransmitter, as well as serotonin, which often leads to depression and anxiety. Some medications, including antidepressants, may also reduce sexual desire. In such cases, considering a medication change or other treatments for anxiety and depression may be helpful.

Which medications for Parkinson’s disease can affect sexual activity?

Gulnara Akhmadeeva: On the other hand, there is a group of medications, such as dopamine receptor agonists (pramipexole, ropinirole), which can enhance sexual desire. However, in rare cases, they may cause hypersexuality or impulse control disorders. If this leads to family issues, it is necessary to adjust the treatment plan by discontinuing or replacing the medication.

How do stress and fatigue affect sexual life in Parkinson’s disease?

Gulnara Akhmadeeva: Moreover, the stress of a chronic illness, fatigue, and lack of sleep can reduce the desire for sex. In such cases, you can shift sexual activity to another time of day, such as in the morning or on weekends. To maintain an active sex life, it is important to openly discuss your issues with your partner and doctor. If you are concerned about depression, fatigue, erectile or mobility problems, be sure to talk to your healthcare provider, neurologist, or urologist. Modern treatment methods, including psychotherapy, meditation, and support groups, can significantly improve your condition.

What specialists can help with addressing sexual activity issues in Parkinson’s disease?

Gulnara Akhmadeeva: If you have problems with erection or urination, such as incontinence or retention, a neurourologist can offer safe medications for treatment. If the disease progresses, with increased tremor, stiffness, or other symptoms, be sure to contact your healthcare provider. The specialists at our center are always ready to help you adjust your treatment and maintain your active sexual life. Wishing you health and goodbye!

Conclusion

Sexual life is not only a possible way to improve health but also a source of joy and intimacy. If you are living with Parkinson’s disease, remember: an active sexual life can be an important element in your fight against the disease. Don’t be afraid to openly discuss this with your doctor and your partner. Life goes on, and you deserve to enjoy it to the fullest!

Problems with erection and other genitourinary disorders (frequent urges, difficult urination) can be corrected with medications that are quite safe for Parkinson’s disease. Information about this, as well as treatment recommendations, can be obtained from our team’s neurourologist – Ivan Alekseevich Kuvin.

And of course, with the progression of the disease and deterioration of the motor condition, you can always contact me and the neurologists at our center.

Sources:

European Journal of Neurology. 2.07. 2019. URL: https://onlinelibrary.wiley.com/doi/full/10.1111/ene.13983

Gulnara Akhmadeeva

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