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Redefining intimacy in Parkinson's disease

Research shows that touch promotes physical and mental well-being: it can reduce heart rate, reduce depression and anxiety, strengthen the immune system, and relieve pain. For couples, touch communicates affection and acceptance, which plays an important role in promoting intimacy.

When people talk about intimacy in relationships, they often focus on sex; However, there are many types of intimacy, such as emotional, intellectual, spiritual, and physical. They are often interconnected and encourage each other. Physical intimacy—both sexual and nonsexual contact—helps foster connection and overall well-being.

Like everything in a relationship, physical intimacy evolves as people change and new challenges arise. With Parkinson's disease (PD), changing roles in relationships, self-esteem problems, stress, medication side effects, and PD symptoms—including movement problems, mood changes, urinary problems and fatigue—can influence sexual health and physical intimacy. Caregivers also experience stress, depression, fatigue, and other health problems over time, which can affect physical connection.

The following tips can help you find new ways to build intimacy with your partner as you navigate the challenges related to PD:

1. Establish a connection with your partner

The pressures of life and the daily stress of living with a chronic illness like PD can cause couples to grow apart. Find ways to stay connected and continue growing together. Share your thoughts and feelings. Spend quality time together. Take a walk, meet for coffee, read aloud to each other, watch a funny movie, or take dance classes; anything that brings you together as friends and reduces stress.

Talking about sex or physical intimacy can be uncomfortable and frustrating. Many couples need help with these conversations. Don't be afraid to seek therapy or join a support group, together or separately.

2. Enjoy the moment

Even just a minute of physical touch can increase "happiness" hormones such as oxytocin and serotonin and reduce cortisol and norepinephrine and other "stress" hormones that can cause anxiety and restlessness. Having expectations that physical contact will lead to a specific outcome can take pleasure out of the experience, create anxiety, or even provoke fear.

Instead of planning for a specific outcome, look for connection and pleasure. Put on some songs, take your time to exchange gentle touches with your partner, such as stroking your face, arms or shoulders, and enjoy the experience, without demands or expectations.

3. Broaden your horizons

It has often been said that comparison is the thief of joy. Defining physical intimacy based on what it means to others, what we have been told it should mean to us, or what it has meant to us in the past can undermine our own experiences.

If you and your partner experience uneven sexual desire, talk about it. Is it due to stress, fatigue, hormones, PD, or another health issue? Sexual desire and activities change over the years for a variety of reasons.

Staying connected through touch is vital to a healthy and loving relationship. Try to meet each other where you are. Of course, if you both agree, sexual activity doesn't have to stop just because it can't be the same. They may need to adapt their techniques, explore modifications, or even plan for those moments that go beyond sensual touch.

4. Talk about intimacy with your healthcare team

Many PE symptoms affect sexual health in men and women, as well as the ability to touch, be close, communicate, or even concentrate. Some of these problems can be treated, but it can be difficult to know who to ask for advice.

For people with Parkinson's and their caregivers, talking to a medical professional they feel comfortable with is often the first step, suggests Gila Bronner. Your neurologist, primary care doctor, or other health care professional can offer advice, treatment, or refer you to the appropriate specialist, such as a urologist, sex therapist, or counselor.

5. Be careful of medication side effects

Dopamine agonist medications, sometimes used to treat PD symptoms, can cause problems with impulse control and hypersexuality. People who experience these problems are at risk of putting themselves or others in unsafe or unhealthy situations. If you notice these side effects, tell your neurologist immediately as these medications may need to be reduced or stopped.

Other medications, such as those taken for high blood pressure or antidepressants, can also affect sexual function. Discuss any concerns about medication side effects or your sexual health with your doctor, who can recommend medication adjustments or appropriate therapies.

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