Its findings are “in line with data showing a close relationship between sexual health and general health both in healthy individuals and in patients with chronic disease,” its researchers wrote, calling on doctors to be watchful of their patients’ sexual life.
Because people with Parkinson’s disease have to deal with important changes in sexual function, “achieving a satisfying intimate and sexual relationship is often a challenge.”
Data from previous studies indicate that patients’ sexual performance is affected by their illness, and men with erectile dysfunction, particularly, have worse disease progression.
It is important to stress, however, that an active sexual life — rather than a person’s sexual function — can serve as a general indicator of good health. But little is known about how sexual activity influences the course of Parkinson’s disease.
A team of researchers with the Center for Neurodegenerative Diseases (CEMAND) at the University of Salerno, Italy, analyzed data from a group of 355 people (238 men and 117 women) with early stage Parkinson’s disease who were enrolled in the PRIAMO (PaRkinson dIseAse non MOtor symptoms) study and followed for two years.
Researchers wanted to understand if an active sexual life associates with better outcomes, and how prevalent sexual dysfunction is among sexually active Parkinson’s patients.
Individuals were asked whether they had been sexually active in the past 12 months. Those who responded positively were then questioned about specific issues that arose in the last month, including reduced sexual desire, impotence, loss of erection, or inability to reach an orgasm.
Motor disability, cognitive abilities, and quality of life were measured using validated scales: respectively, the UPDRS‐III, MMSE, PDQ‐39 and EQ-VAS scales. Depression and other non-motor symptoms were also evaluated.
Early stage Parkinson’s was defined as a score of 2 or lower in the Hoehn and Yahr (H&Y) scale, a five-stage measure of disease progression and disability level, at the study’s start.
Data showed that patients’ sexual activity progressively dropped over time, with 56.3% of patients reporting to be sexually active at the study’s start and 50.8% reporting the same two years later. Men were twice as likely to be active as women.
Nearly half of sexually active men complained about erectile dysfunction (difficulties with erection and impotence) and orgasmic disorders at every time point.
Sexually active men tended to be younger and to have had an earlier onset of symptoms than non-active male patients.
Noticeably, sexually active men were less likely to have gastrointestinal problems and less likely to be affected by apathy (a general lack of motivation and interest) than those not sexually active. The odds of lower chances of these non-motor symptoms were 44% (gastrointestinal problems) and 58% (apathy).
Male patients with an active sexual life were associated with less severe motor disability, better quality of life, and lower depression scores. At two years, they were taking levodopa less frequently and had lesser fatigue as well as attention or memory problems, “reflecting a milder motor impairment and disease progression,” the researchers wrote.
No association between sexual activity and disease symptoms were shown for women, which researchers suggested might be because of gender differences in symptoms and attitudes toward open discussion of sexual drive and difficulties, and the smaller group of female patients in the study.
“The most novel finding of our analysis was that, irrespective of disease severity as evaluated by the H&Y, sexually active men displayed distinctive demographic and clinical features,” the researchers wrote, adding that the findings suggest “that sexual activity might be associated with reduced motor and non‐motor burden and milder disease progression in men with early [Parkinson’s disease].”
They added that, from a “clinician’s perspective, examination of a patient’s sexual life is often neglected during the clinical interview.”
While further studies are needed to confirm such data, they “should prompt movement disorders specialists to periodically inquiry about their patients’ sexual life,” the team concluded.
It is important to note that all correlations between sexual activity and patient outcomes were controlled for patients’ age and disease duration.