Warning: This article contains adult themes and terms.

Each year, top Parkinson's experts from around the world who treat people with Parkinson's at a Parkinson's Foundation-designated Center of Excellence (a department or clinic within a hospital that specializes in PD) meet to discuss what latest in Parkinson's research and treatments. This article summarizes the 2018 Centers of Excellence Leadership Conference (CLC) presentation on sexual dysfunction by Gila Bronner, MPH, MSW, CST, director of sexual therapy at SHEBA Medical Center in Israel .

Jessica made an appointment with Gila Bronner, MPH, MSW, CST, a sex therapist, to discuss a specific topic: how could she address her husband's drooling, which is interfering with her sex life? Even though her husband was the one living with Parkinson's disease (PD), some symptoms affected both of them.

Intimacy problems and sexual dysfunction are a "couple problem." It affects both members of the couple. One person's sexual dysfunction often results in the same effect on his or her partner. For example, when a man experiences sexual dysfunction, his partner is more likely to also experience sexual dysfunction and dissatisfaction.

There is a high prevalence of sexual dysfunction in PD, with problems ranging from erectile dysfunction to reduced desire and frequency, vaginal dryness, orgasm difficulties, and more. According to one study, people with PD rate sexual dysfunction as one of their 12 most bothersome symptoms (Politis, et al., 2010). Another study cites that 41.9 percent of men and 28.2 percent of women cease sexual activity after being diagnosed with PD (Bronner, et al. 2004).

Sexual dysfunction in PD can be exacerbated by depression, anxiety, pain, and movement-related symptoms, which can affect desire, erectile dysfunction, and sexual satisfaction. Sexual dissatisfaction has been associated with movement symptoms in men, anxiety in women, and depression in both sexes.

As a sex therapist, Gila reminds her patients that it is important to remember that sexuality is not just about sex and orgasms; Its emotional, non-sexual physical and intimate aspects play an important role. Intimate contact and sexual activity contribute to a better quality of life and overall health. They are associated with emotional and physical relaxation, better self-esteem, greater vitality and well-being, and closeness between couples.

The increase in oxytocin that comes from massage and physical touch can even reduce pain. Older people who continue to engage in sexual activity have better overall cognitive functioning (Hartmans, et al. 2014). Therapeutic touch has even been shown to decrease the behavioral symptoms of dementia (Woods, et al. 2005).

There are many alternative intimate and sexual activities to treat sexual dysfunction, such as non-penetrative intercourse (sexual activities other than sex), self-stimulation, nondemanding touch (relaxing and pleasurable touch), open sexual communication, compensatory strategies, and sexual supports and erotic thoughts and fantasies.

Intimacy advice from people with PD and their partners

1.Plan sex for when motor symptoms are at a minimum.

2.Apply oily lubricants to the skin to lessen the effects of tremor.

3.Use sexual supports.

4.Plan positions in advance with minimal movements between positions.

5.Use lubricants for penetration during intercourse and be sure to read the instructions on the lubricant before you begin.

6.Use satin sheets for easy movement.v

7.Perform intimacy training and erotic tasks.

8.Reduce stress and burden on your partner.