Between 30-90% of people living with Parkinson's disease (PD) may experience intimacy problems. These challenges can affect both the person living with Parkinson's and their partner.

Although it may seem taboo to talk about topics such as sex and the human body, understanding the impact of non-motor symptoms of PD such as sexual dysfunction and incontinence can help you live well.

Explore intimacy

Sexual dysfunction is a common problem among the general population, but it is one of the most overlooked aspects of PD. Sexual dysfunction can encompass a variety of symptoms including sexual desire/arousal, ejaculation, sexual pain, and erectile dysfunction.

Because Parkinson's disease affects dopamine production in the brain, changes in neurotransmitter levels can impact sexual function and cause other symptoms of sexual dysfunction.

There are many types of sexual dysfunction, as well as options to treat them:

1.Sexual arousal. To help improve sexual arousal or libido, doctors tend to first examine other possible causes, such as stress and anxiety. Treatments include types of therapies such as hormonal and sexual, which usually also include your partner. You can also take oral medications to improve sexual arousal.

2.Ejaculation. To assist ejaculation, behavioral techniques and/or vibratory stimulation may be effective. There are also oral and topical medications to relieve this symptom.

3.Erectile dysfunction. Lifestyle modifications and oral medications can help treat this symptom. Other possible treatments are Botox injections and surgery, which is rare.

4.Sexual discomfort. There are different interventions that can be used to reduce sexual discomfort, such as vaginal estrogen, which comes in various presentations. Additionally, behavioral and physical interventions, as well as pelvic floor physical therapy, can help reduce discomfort.

Sexual dysfunction is a common problem for many individuals, but it is important to remember that these problems can be common in people living with PD. Fortunately, there are several treatments available to help combat sexual dysfunction, depending on what you are experiencing and what works best for you.

Tips for intimacy and PE

1.Increase open communication

2.Perform intimacy training and erotic tasks

3.Work with medical staff to reduce the effects of medications on sexual function

4.Understand each other's comfort and physical limitations

5.Practice increasing intimacy and satisfaction through sexual stimulation without intercourse, then begin to include it again; This is known as approximation to intercourse.

Understanding incontinence

Incontinence is the lack of voluntary control over urination or defecation. Urinary problems are one of the most common non-motor symptoms in Parkinson's disease, affecting between 40 and 70% of people living with PD. These problems include urgency and/or frequency of urination, dribbling, and infections.

In the human body, the brain, spinal cord and nerves interact with the bladder and sphincter. Nerve injuries or damage, which occur in neurodegenerative diseases such as Parkinson's, can affect signaling in the bladder and cause urinary symptoms.

First, talk to your doctor to rule out other medical problems, such as bladder or urinary tract infections. If symptoms persist, there are various treatments to help cope with urinary problems:

1.Behavioral modification includes scheduled voiding (going to the bathroom every hour) and avoiding dietary irritants such as spicy foods and caffeine.

2.Pelvic muscle training can be an effective method to stop urinary problems.

3.Oral medications and bladder injections, such as Botox, are common treatments.

4.Surgery may be an option, but it is rare.

Parkinson's disease can affect life in many ways, especially when it comes to intimacy and incontinence. These symptoms can be difficult to control, but there are strategies and treatments designed to help. With the right support and open communication with their care team, people living with PD can maintain a good quality of life and enjoy satisfying relationships.

Tips for incontinence and PE

1.Communicate openly with your healthcare professional and loved ones

2.Be attentive and go to the bathroom frequently even if you don't need it

3.Reduce caffeine consumption

4.Keep a bladder diary to record fluid intake and toileting habits