Parkinson's disease and sexual issues

Parkinson’s disease can affect a person’s sexuality. It is a progressive neurological condition that affects the control of body movements. This may cause sexual problems (dysfunctions) or affect a person’s relationships. Medication side effects can also include reduced sexual desire and feeling or an increase in desire (hypersexuality).

Other factors that may cause sexual problems for a person with Parkinson’s include depression, grief and anger, stress, problems with body image or self-esteem, and disease-related fatigue. Parkinson’s can affect the partner’s sexuality too.

Open communication and understanding are the best remedies for relationship and sexual problems. Professional counselling or medical treatment can also help. However, always see your doctor if you are concerned about your medical condition, treatment, sexuality or sexual relationship.

The autonomic nervous system
Sexual response and function are controlled by the autonomic nervous system. Parkinson’s affects the autonomic nervous system and can directly cause a range of sexual problems (dysfunctions). For example:

• The slowness of movement (brachykinesia), tremor and rigidity may interfere with the practicalities of lovemaking.
• Men can have problems with getting or keeping an erection (impotence).
• Men may be unable to ejaculate.
• Women may experience vaginal dryness.
• Reaching orgasm may be difficult, regardless of gender.
• In some cases, a person may develop hypersexuality, which is a compulsive drive to have sex very frequently. This is due to medications used to treat symptoms of Parkinson’s.

• Negative body image
• Reduced self-esteem
• Depression and grief
• Anger and stress
• Disease-related fatigue.

• Feelings associated with their loved one’s diagnosis including fear, anxiety, depression and grief
• Coping difficulties
• Tiredness from taking on more responsibilities
• Loss of sexual interest in the partner because of Parkinson’s symptoms (for example involuntary movements or changes in physical appearance)
• Changing roles from partner to carer.

• The person with Parkinson’s has reduced mobility, which may force them to take a more passive role in lovemaking.
• Symptoms of Parkinson’s tend to worsen at night, which may prompt the couple to sleep in separate bedrooms. This arrangement reduces opportunities for spontaneous sex.
• The couple (especially those who have been together for a long time) may have firmly established roles. Parkinson’s can dramatically change each person’s role and this sudden unfamiliarity may stall aspects of the relationship, including sex.
• The way each person handles the diagnosis and daily demands of Parkinson’s may cause friction. Communication problems can spill over into the bedroom.

• Learn about the impact Parkinson’s and its treatment can have on sexuality.
• Appreciate and recognise the emotional stress you are both going through, even if you are going through it differently. Make every effort to show love, respect, warmth and togetherness in non-sexual ways.
• Talk frankly and openly about sexual needs. Communication is the best remedy for all types of relationship problems.
• Experiment with different routines; for example, switch lovemaking to the morning when Parkinson’s symptoms tend to be less pronounced or when you have better mobility (your ‘on’ time).
• Place the emphasis on different physical expressions of lovemaking: for example foreplay, touching and kissing rather than penetration.
• Explore and practise different, comfortable positions for successful and pleasurable penetration.
• Adopt new sexual roles according to you and your partner’s abilities.
• Find new solutions for physical stimulation (touch, arousal, orgasm).
• Work together with medical staff to reduce the effects of medications on sexual function.

• Seek assistance from a counsellor who is trained in sexual health.
• See your doctor for information, advice and referral on any type of sexual difficulty. If you feel embarrassed, consider printing out this fact sheet and highlighting relevant sections for your doctor to read.
• If talking and communicating with your partner is difficult, counselling may help. Your doctor can refer you to an appropriate service.
• Sexual dysfunction can be medically treated. For example, certain prescription drugs can stimulate an erection, while oestrogen medications or water-soluble lubricants can ease vaginal dryness.
• Regular exercise reduces fatigue by increasing fitness and stamina. If you are not exercising already, see your doctor for guidelines on appropriate activities.
• Some studies have found that depression impacts on sexuality more than the condition itself in people with Parkinson’s. Talk to your doctor about treatment options for depression if you feel you are experiencing this.

• Your doctor
• A specialist – which may include a neurologist, urologist or gynaecologist
• Physiotherapist
• Movement Disorders Clinics – Sexual Counselling Service Tel. (03) 9265 1411
• Family Planning Victoria Disability Unit Tel. (03) 9257 0100
• Parkinson’s Victoria Tel. (03) 9551 1122 or 1800 644 189

• A person who has Parkinson’s faces many challenges, including the possibility of reduced sexual feeling and function.
• Parkinson’s can affect the partner’s sexuality too.
• Communication is the best remedy for all types of relationship problems, including sexual problems.
• Always see your doctor if you are concerned about your medical condition, treatment, sexuality or sexual relationship.

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