Sexual activity can be made more complicated by chronic disease. How does having a condition that impacts motor skills and has mental side effects contribute to sexual life?
A recent study sought to understand how Parkinson's disease (PD) and factors within PD such as age, duration of disease, severity of disease, depression and anxiety, affected sexual lives.
The results showed an overall decline in sexual functioning in those living with PD.
Two researchers in the Czech Republic, Petra Kotkova, PhD, of the Centre for Psychiatric Rehabilitation and Petr Weiss, PhD, of the Charles University and the General Faculty hospital in Prague examined 103 people in the early and middle stages of PD.
The study participants all had current sexual partners, were 99 percent heterosexual. About 2 percent were single, 60 percent were married, 24 percent were divorced and just less than 14 percent were widowed.
Of the participants, 4.9 percent were employed, 87.4 percent were old-age pensioners and 7.8 percent were on disability pension.
All participants were currently taking L-DOPA, a common PD medication and most were on other medications as well. Fifty-two percent were male and 48 percent were female.
Two questionnaires that examined psychological status and sexuality were distributed. Study participants completed the questionnaires and submitted them anonymously.
The questionnaires were different for men than women. Both genders rated the progress of their disease and inventoried depression and anxiety.
The men were given a male version of a sexual satisfaction inventory and questioned about erectile function. Women were given the female version of the sexual satisfaction inventory and questioned about female sexual function.
The researchers found that the total average score of all men and women with PD indicated problems in sexual life. The problems were heavily influenced by symptoms and consequences of the illness.
Of the sexual dysfunctions, men experienced the most difficulties in erectile dysfunction and disturbances of ejaculation. Women experienced the most difficulties with inadequate lubrication and achieving orgasm.
Women reported more difficulties and less satisfaction with sexual life than men. In the Czech general population of the same age, men are usually the gender than reports less satisfaction.
For men, motor symptoms were the primary source of dissatisfaction. For women, depression and anxiety were a greater problem.
Depression played a major role in both genders sexual dissatisfaction.
Parviz Kavoussi, M.D., a a urologist at Austin Fertility & Reproductive Medicine in Austin, Texas points out that sexual function begins in the brain.
"Patients with depression, anxiety, or just too much stress will almost certainly have these factors carry over to their sexual lives as well, overall worsening their quality of life and even worsening the depression, anxiety and stress," said Dr. Kavoussi.
Medication played a varying role in the sexual satisfaction of PD patients. Some experienced hypersexuality while others experienced reduced libido.
Most medications for PD contain dopamine replacements or dopamine stimulants. These dopamine agonists have been shown to increase libido in most people.
Another important factor in this study is the effect of age on sexuality, which was accounted for by comparing the rates of the PD patients to those in the general population. Although people of retired age commonly have active and rewarding sexual lives, low libido and erectile dysfunction can develop with age.
When it comes to the older population, sexuality is often seen as taboo and is not discussed. Overcoming this taboo is increasingly more important as people continue to live longer and incidence of PD becomes more common.
The research study was published in the June edition of Clinical Neurology and Neurosurgery.
The authors report no conflicts of interest.