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How does Parkinson disease affect your sexuality?



Living with Parkinson disease for 12 years now, I continue to discover the positive and/or negative, as well as direct and/or indirect impact of this disease on me as a patient as well as on people around me. Some of my friends with Parkinson’s approached me for some embarrassing symptoms like sexual problems as well as urinary and/or faecal incontinence.


I’d like to talk about the 1st one, and will be covering the others in my future posts.


If you have Parkinson's disease, you surely have been felt an impact on your sexual self-esteem at some point. Whether positive or negative impact the disease has had on you, you should have found yourself less/more desirable or attractive, or less/more desiring to have sex.

If you are a carer of someone with Parkinson’s, the impact is inevitable on you as well. You might think that your desire to have sex with your partner is too demanding. Also, the new dynamics of the carer vs. cared-for relationship is difficult to accept for some couples, which destabilizes the sexual appetite for both.


With or without Perkins’s, our sexual relationship evolves over time. But the difficulty with Parkinson’s is that it requires the couple to:

  1. Modify what they do together to account for changing physical abilities.

  2. Reshape their expectations to ensure everyone is comfortable and still enjoying the other.

  3. Be open about the fact that Parkinson is a life-changing condition, but agree mutually that the person is still the same.

  4. Reassure each other to not feel compelled to stay all the time together for fear of diminishing ability, or expressing love for one another.

  5. Work jointly to find another form of intimacy that pleases both partners.

If you've been in a relationship where both partners felt comfortable and confident discussing about your mutual sexual desires and limitations, it should be easier to talk/accept the challenges that Parkinson's can bring. If your relationship was an uncomfortable one before Parkinson’s take place, it’ll require more efforts from both partners to overcome those challenges.


Many people with Parkinson disease experience sexual difficulties, due to condition's physical effects on things like coordination and speed of movement, emotional challenges like low mood or depression. However, the good news is that Parkinson's disease does not affect everyone's sexual functioning!


WHAT FACTORS CAN CONTRIBUTE TO SEXUAL PROBLEMS?



With or without Parkinson's disease, when your sexual responses are confused, you may experience difficulties with sex. Movement issues, fatigue, and depression are all causes that can contribute to your sexual problems. Because these difficulties are common in all people, it may be difficult to judge whether a problem is caused by your condition or not.


Some Parkinson's symptoms can interfere with sexual activity, because the nervous system affects the physical ability to have sex. Therefore, people with Parkinson's are more likely to have problems such as:

  • Movement issues such as stiffness, rigid muscles, and slowness of movement, can interfere with sexual activity. Ensuring you take your medication properly may help alleviate these symptoms; speak with your specialist or Parkinson's nurse about this. They may also be able to advise you on sexual positions that will benefit you.

  • Fatigue is a symptom of Parkinson's disease. If this is an issue, try having sex or being intimate at a different time of day when you have more energy.

  • Problems with the bowel and bladder for fear of incontinence, which may make you or make your partner hesitant to engage in sexual activity.

  • Some Parkinson-related medication could have side effects on your sexual appetite. Some antidepressant medications can cause a decrease in sexual desire, arousal issues, and delayed or absent orgasms.


1. HYPERSEXUALITY:

Some medications like Dopamine agonists, in particular levodopa, can cause a side effect for some people, that is called Impulsive and Compulsive behaviour. This means that the person is focused on sexual feelings and thoughts. Their sexual impulses become more intense, which can make them be felt at inappropriate times or towards people other than a partner. This can be distressing for the person and those around them. There is also the risk that someone will behave in a socially inappropriate manner, or perhaps breach the law, if they are hypersexual.

This sort of behaviour may have a significant influence on both the individual affected and others around them. Sexual delusions and hallucinations, such as believing a spouse is having an affair or that others are having sex when they are not, may accompany it.

If this adverse effect is minor, some couples may welcome the extra sex. However, it may become a tough and unpleasant condition for the partners, especially if the sexual cravings feel out of control and out of character.

If you feel you are experiencing hypersexuality, please talk to your specialist or Parkinson nurse. In most cases, a change in medication doses solves the problem and get things back to normal. If not, you may need to refer to a psychosexual therapist for extra help.

If you are a partner of someone who is experiencing this behaviour and not realising it is becoming a problem, you need to discuss it with a health care professional.




2. LOWERED SEX DRIVE:

In some other cases, the opposite can happen. Some people with Parkinson disease and their spouses experience decreased sexual desire. This is generally due to the psychological and emotional impact (exhaustion, stress, sadness, or poor self-esteem) of the diagnosis rather than the ailment itself.

Before getting therapy, attempt to rule out any emotional factors, such as stress or marital conflicts.

General weariness and despair, which are typical in Parkinson patients, can also reduce desire. In most cases, your specialist can help you treat any depression or mood problems you may be experiencing.

However, there are a few things that you can do on your own to prepare for closeness or sex with your partner:

  • Take some time to unwind in the bath.

  • Get a sensuous massage.

  • Try to do something unusual or playful together.

  • Revive the spark by investing in new lingerie or sex toys, watch an arousing video or read erotic stories to each other.

The more sensual you can be together, the more likely it is that arousal will occur in a natural way.

If you are suffering a loss of sexual interest or desire, you need to refer to a relationship counsellor or a psychotherapist for help.



3. ORGASM PROBLEMS:

Orgasms can be decreased or non-existent for both men and women. Some men may have issues with premature or delayed ejaculation.

Treatments for orgasming issues may include psychosexual therapy or cognitive behavioural therapy, which can the partners to find more effective sexual communication methods.

Before seeking medical help, you may want to try a couple of things:

  • Reduce any source of anxiety in your daily life

  • Seek the methods that you enjoy the most

  • Get to know your partner’s needs and desires

  • Pelvic floor exercises for women


It's best to talk to your specialist or Parkinson's nurse about your options so you can continue to get the most out of your medication.


But as usual, I'm here to talk if you need to.







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