Important note for readers: We acknowledge that some of this content may cause discomfort. But as an organisation that values courage, inclusion and integrity, we believe in the cultural and ethical significance of challenging stigma around sex and intimacy, especially as sexuality, libido and general health can change over time, for all people, in all communities.
Together, let’s remove the burden of indignity and embrace any challenges that may lie ahead with empathy and sincerity, as well as with support.
How Parkinson’s can impact sexual health
Difficulties with sex happen when something disrupts your physical and emotional responses. This can affect many people, not just those with Parkinson’s. But the physical ability to have sex is affected by the nervous system, so it’s common for people with neurological conditions, such as Parkinson’s, to experience problems with sexual function.
The five most common sexual problems for people with Parkinson’s are:
- Loss of sexual interest or desire (reduced libido)
- Sexual pain (in women)
- Problems with arousal (poor or absent erections in men, or, in women, lack of sexual excitement or problems with genital arousal)
- Problems reaching orgasm or ejaculation
- Hypersexuality – a type of impulsive and compulsive behaviour, where someone is focused on sexual feelings and thoughts.
Parkinson’s symptoms that can impact sex and intimacy
The following Parkinson’s symptoms can have an impact on sex and intimacy:
Motor symptoms:
Non-motor symptoms:
Autonomic (acting or occurring involuntarily) symptoms:
- Pain
- Blood pressure fluctuations
- Bladder difficulties and constipation
- Erectile dysfunction
- Vaginal dryness
- Loss of sense of smell
The impact of Parkinson’s medications
Parkinson’s medications can sometimes diminish sexual desire and reduce sexual response, with hypersexuality as a rare side effect.
Hypersexuality has been identified as a side effect of Dopamine Agonists medication (Pramipexole, Rotigotine, Ropinirole). It has been seen in connection with other impulse control disorders, like hobbyism, gambling and eating. Hypersexuality can also show up as:
- Increased desire to engage in sex
- Obsessively viewing pornography
- Sexual adventurism
- Affairs and casual sex.
When you are experiencing an impulse control disorder, like hypersexuality you are often not aware of the increase in desire or the behaviours and their impact on those around you. It is important to listen to your partner and speak with your GP or Parkinson’s specialist about any medication-related side effects.
Important Note: Do not stop the Dopamine Agonist medication without consulting with a medical professional.
Sexuality issues and Parkinson’s
Besides the effects of the condition and any prescribed medications, other factors that may cause sexual problems for a person with Parkinson’s include:
- Negative body image
- Sleep difficulty
- Reduced self-esteem
- Depression and grief
- Anger and stress
- Continence issues, constipation and urinary urgency/frequency.
Although this information may sound daunting or worrisome, the important thing to remember is that you are not alone. Sexual difficulties have been reported by approximately 75% of people living with Parkinson’s. However, help is available and a healthy sex life is still possible with Parkinson’s.
Sexual issues for partners of people living with Parkinson’s
Parkinson’s can affect your partner’s sexuality too. Issues may include:
- Feelings associated with their loved one’s diagnosis, including fear, anxiety, depression and grief
- Coping difficulties
- Tiredness from taking on more responsibilities
- Loss of sexual interest in the partner because of Parkinson’s symptoms, e.g. involuntary movements or changes in physical appearance
- Changing roles from partner to carer.
Navigating changes with loved ones
Whether you are someone who lives with, or cares for someone with Parkinson’s, your relationship may be affected throughout the progression of the condition. Some relationships may be affected by the following issues:
- How each partner reacts to the diagnosis
- Changing roles in a relationship, such as becoming a carer
- Expectations of how someone might be affected by Parkinson’s
- Communication struggles caused by the condition
- Self-image and feelings of isolation
- Symptoms of Parkinson’s
- Emotional changes, such as stress and anxiety.
Every couple affected by Parkinson’s has a different experience. Some practical suggestions to overcome sexual issues include:
- Talk frankly and openly about sexual needs. Communication is the best remedy for all types of relationship problems
- Appreciate and recognise the emotional stress you are both going through, even if you are going through it differently. Make every effort to show love, respect, warmth and togetherness in non-sexual ways
- Make time to learn more about the effects that Parkinson’s and its treatments can have on sexuality. There are many resources available through Fight Parkinson’s. Our webpage on Parkinson’s and relationships is a good place to start.
Parkinson’s, gender diversity and sexual orientation
No matter how you identify, or where you sit on the spectrum of sexual orientation, it is important to note that all communities experience changes in intimacy and desire and are under assessed in relation to sex and sex difficulties.
Fight Parkinson’s believes that all people and communities deserve access to Parkinson’s information, resources and support services. While research on the LGBTIQA+ community and those who are non-cisgendered or genderfluid (including transgender and non-binary persons) is currently limited, we look forward to sharing more about Parkinson’s care with these communities in the future.
In the meantime, we encourage community members and healthcare professionals to complete the free online course ‘LGBTIQA+ and living with Parkinson’s’ via the Fight Parkinson’s Community Learning Hub.
For women and men with Parkinson’s, evidence shows that they experience different symptoms from one another:
Women:
- Increased tremor-dominant Parkinson’s
- More dyskinesia
- Pain is a significant symptom
- More sleep difficulties
- Increased depression and anxiety
- Higher levels of fatigue and apathy
- Increased constipation.
Men:
- 1.5 times more likely to develop Parkinson’s
- Have a more rapid progression of symptoms
- More cognitive symptoms
- More hallucinations.
Women and men are also different when it comes to sexuality:
- Responses and feelings of intimacy and arousal are different
- Intimacy and connection are identified as more important by women
- Action, performance and orgasm are seen as important to men.
It’s important to remember that feelings change for every person as they age. Parkinson’s and ageing in general can reduce fluctuations in desire, but not stop them.
Fertility, pregnancy and reproductive health
Though research into Parkinson’s and the stages of pregnancy – including pre-conception, childbirth and post-partum care – remains limited, global data collection through registries like, ‘PregSpark’ remain vital to refining our understanding of, and ability to provide women with the comprehensive, evidence-based guidance they need to make informed decisions about their reproductive health.
Fertility, pregnancy and reproductive health for people living with Parkinson’s is an area that Fight Parkinson’s aims to expand on in the future, when more information becomes available.
Practical strategies and solutions
In 2024, the Davis Phinney Foundation Director of Education and Content, Devon Fulford, conducted a webinar with Lisa Thomas and Daniel Fleshner, two certified sex therapists, about the ways Parkinson’s may affect sex and intimacy.
Key notes to take away from the webinar
- Open and honest communication is key – a counsellor may provide guidance in navigating these conversations
- Attend medical appointments together to learn about physical limitations and changes that you and/or your partner are experiencing
- Not all intimacy needs to be sexual intimacy in order for it to be positive and meaningful – try other forms of connection, i.e. holding hands, cuddling, massage, etc
- For many Parkinson’s medications, there’s a period after taking them, when their effects are at their peak, i.e. “on” times. This window of time can be ideal for engaging in sexual activity
- For a lot of couples, even those who do not include someone with Parkinson’s, scheduling intimacy leads to more intimacy.
Support is available
Please remember that professional support is available. Contact the Fight Parkinson’s Multidisciplinary Health Team for a confidential discussion on the challenges you are facing or assistance finding counselling services in your area.
Phone
Health information line: Free call 1800 931 031*
*A free translation service is available on this line.
Email
[email protected]
For people who live with Parkinson’s, or care for someone who lives with the condition
Click here to complete the ‘Sex, intimacy and Parkinson’s’ course that shares information about sexual function and Parkinson’s, dispels some common myths, and shares practical solutions for the changes you might be experiencing.
For healthcare professionals
Click here to complete the ‘Sex and intimacy changes in Parkinson’s’ course that will help you to develop a toolkit for supporting patients, clients or residents to address changes that impact sex and intimacy.
