Redefining Sexual Identity with Parkinson’s Disease

Individuals with Parkinson’s disease often experience sexual health issues that significantly impact their lives. A Michigan Medicine social worker offers help.

5:00 AM

Author | Jane Racey Gleeson

Couple holding hands

 

Discussions about sexual health can be awkward, but for Daniela Wittmann, Ph.D., MSW, they go with the territory. As a social certified sex therapist, she sees patients with sexual health issues at the Michigan Medicine Center for Sexual Health and in the Department of Urology. She also discusses these types of issues with Parkinson's disease patients during support groups geared toward patients and their partners.

"Men with Parkinson's disease may experience issues such as lack of sexual desire, low libido, erectile dysfunction and difficulties with orgasm at a greater rate than the general population," Wittmann says. "Women with Parkinson's may also have low libido and orgasm difficulties in addition to vaginal dryness."

Parkinson's disease affects the neurons in the brain and causes dopamine-producing nerve cells to die. Dopamine is a chemical that transmits signals in the brain to coordinate smooth muscle movement, which is critical to sexual function.

A decrease in dopamine can impact the nerves that control sexual organs. For men, this can impact their ability to get or maintain an erection. Women may experience loss of vaginal lubrication and issues with orgasm.

MORE FROM MICHIGAN: Sign up for our weekly newsletter

For both sexes, a reduced level of dopamine can result in a decrease in sex drive. Lower levels of dopamine can also result in balance issues, muscle stiffness and tremors — all issues that can impact a sexual relationship.

Associated illnesses, medications and advanced stages of Parkinson's disease can also contribute to sexual dysfunction.

First steps

"The first step is recognizing and addressing common sexual problems in patients with Parkinson's disease," says Wittmann. Her focus is on assessing a patient's sexual dysfunction and determining the most effective method of treating it.

"It's important to find out if the sexual issues have been lifelong or whether they started with PD," Wittmann says. "Usually we find out that the issues are directly related to the condition — both the physical nature of PD and the amount of distress the diagnosis and sexual changes are causing the individual and his/her partner.

WATCH: Daniela Wittmann's talk on sexuality and parkinson's disease

"We also want to find out how important sex is to them as an individual and as a couple. We find that not everyone needs to work on maintaining sexual intimacy. It depends on how important it is to the relationship."

Patient assessment

Wittmann's patient assessment is based on several objectives:

  • Opening up the conversation about sexual concerns.
  • Assessing physical symptoms that may interfere (urinary, bowel or movement issues).
  • Discussing how the individual responds to his/her sexual issues (including loss, depression or anxiety).
  • Evaluating the partner's attitude regarding the situation and his/her sexual concerns.
  • Discussing any factors that impact the ability of PD patient to have pleasure.

She says it's also important to find out if a patient's sexual dysfunction occurs in all situations or only in certain types of situations, or with certain partners. And how much distress the individual is experiencing.

Sex therapy

The goal of sex therapy, Wittmann says, is to:

  • Improve the patient's sexual function.
  • Enhance communication between partners.
  • Improve sexual interactions, including expansion of an individual's sexual repertoire.
  • Boost self-esteem.
  • Alleviate symptoms of depression or anxiety.

Wittmann points out the need for other disciplines when treating PD patients.

LISTEN UP: Add the Michigan Medicine News Break to your Alexa-enabled device, or subscribe to our daily updates on iTunesGoogle Play and Stitcher.

"A multidisciplinary approach is important and may include behavioral therapists, urologists, pelvic floor rehab physical therapist, sex therapists, gynecologists for women, mental health providers and physicians who manage chronic conditions."

She says there is often a feeling of loss and uncertainty as well as a grieving period, which adds to the stress of a Parkinson's diagnosis. But, Wittmann stresses, "Many patients find that exploring and redefining their sexual identity helps strengthen their relationship as they move forward with a new normal."


More Articles About: Brain Health Parkinson's Disease Neurological (Brain) Conditions
Health Lab word mark overlaying blue cells
Health Lab

This article is from the Health Lab digital publication.

Media Contact Public Relations

Department of Communication at Michigan Medicine

MichMedmedia@med.umich.edu

734-764-2220

Newsletter

Get a weekly digest of medical research and innovation, straight to your inbox.

Subscribe
Featured News & Stories Man and woman couple holding puppy smiling
Health Lab
Hearing is healing
A patient finally gets answers to his health concerns, thanks to “a doctor who listened closely” to his symptoms.
Complimentary alternative therapies
Health Lab
Exploring Alternative Therapies for Parkinson’s Disease
For treating Parkinson’s disease, a Michigan Medicine neurologist advises considering conventional and alternative treatment options.
Bathroom image
Health Lab
Parkinson’s Disease and Your Bladder
A Michigan Medicine urologist discusses treatment options for patients diagnosed with Parkinson’s disease who may be experiencing urinary tract issues.
Health Lab
A Caregiver’s Guide to Parkinson’s Disease Psychosis Treatment
Read more about the actions you can take to help if you suspect your loved one is displaying symptoms of psychosis with Parkinson’s disease.
A painting of a brain with Parkinson's disease
Health Lab
Deep Brain Stimulation for Parkinson’s Disease: Is It Right for You?
Deep brain stimulation surgery may help with Parkinson's disease symptoms. Learn more about the deep brain stimulation procedure and types of DBS surgery.
microscope cells glioma
Health Lab
Researchers circumvent radiation resistance in subtype of brain tumors
University of Michigan Rogel Cancer Center researchers find ZMYND8 gene plays a critical role in conferring radiation resistance on brain tumors with IDH1 mutation.