Parkinson's disease (PD) is a progressive neurodegenerative disease with multiple manifestations including both motor and non-motor symptoms. One manifestation of PD that is often overlooked is the sexual dysfunction (SD) that patients may experience. Individuals with PD can experience impairment in sexual desire, arousal or lubrication, orgasm, ejaculation, pain and the physical aspect of intimacy. This article aims to provide an overview of the current practices in the evaluation and treatment of sexual dysfunction in men in the context PD. Note that this article focuses on the male population as it reviews the available American Urology Association practice guidelines many practitioners follow, which focus on the male population. Sexual dysfunction guidelines for the female population are much more limited, and future work should review the existing literature and gaps to provide a more robust understanding of sexual dysfunction in PD. PD represents a particularly vulnerable population for development of sexual dysfunction given the multifactorial nature of its manifestations. Given its profound impact on not only the patient, but their partner, it is important to be aware of the various manifestations of SD when evaluating individuals with PD. Through thorough history taking and targeted psychosexual evaluation, we as practitioners can ensure a more holistic and comprehensive approach to caring for individuals with PD.
Patients with Parkinson's disease (PD) can experience a myriad of symptoms, ranging from movement symptoms such as tremors to non-movement symptoms such as depression. An often-overlooked symptom associated with PD is sexual dysfunction, which refers to impairment in any component involved in normal sexual function. Individuals with PD can experience changes in sexual desire, arousal or lubrication, orgasm, ejaculation, pain, and the physical aspect of intimacy. It is important that clinicians taking care of individuals with PD are aware of these symptoms as these can have profound impact on the quality of life for the patient as well as their partners. Most initial interventions for sexual dysfunction include non-invasive treatments such as behavioral modification and oral pharmacotherapies. For more advanced treatments, dedicated sexual health clinicians may provide additional expertise. Our manuscript provides a broad and generalized overview of sexual dysfunction for clinicians who evaluate and treat individuals with PD. Note that the article describes practices and treatments directed mostly towards the cis-male population, although the general principles described are applicable regardless of a patient's gender or sexual preferences.
Journal of Parkinson's disease. 2025 Nov 28 [Epub ahead of print]
Anessa N Rafetto, Gillian R Murray, Matthew J Ziegelmann
Department of Urology, Mayo Clinic, Rochester, MN, USA.