The impact of Parkinson disease on patients' sexuality and relationship.

Abstract

This study aimed at examining the impact of Parkinson disease (PD) on patients' sexuality and relationship and to evaluate gender-specific differences. Using a standardized questionnaire on sexual functioning in chronic diseases (SFCE), the impact of PD diagnosis on 38 domains of sexuality before and since PD diagnosis was evaluated retrospectively in 53 consecutive patients in a relationship. Changes in self-assessed ratings on a four-point Likert scale were determined for all patients. In addition, gender-specific differences and the influence of age, depression (BDI-II), medication, disease severity and disease duration on domains of the SFCE were calculated. The importance of non-sexual relational aspects, such as talking about feelings or tenderness increased for both genders after PD diagnosis, especially in women. Sexual function, such as frequency of intercourse, sexual arousal, subjective abnormal sexual fantasies or sexual satisfaction deteriorated in both genders, especially in men. Some sexual aspects improved in women but worsened in men after PD diagnosis. This includes frequency of orgasm dysfunction, fear not to fulfill sexual expectations of the partner, avoidance of sexual acts, withdrawal from relationship, increase of thoughts about divorce, or increase of dissatisfaction with sexuality and relationship. With age, thoughts about divorce declined. With disease duration, frequency of tenderness with the partner increased. Depression unexpectedly correlated with higher frequency of intercourse. Dopaminergic dosage influenced stability of the relationship negatively. PD influences patients' sexuality negatively, independently of age, disease duration or disease severity and men show greater sexual dysfunction and impairment of their sexual relationship than women.