Sexual dysfunction and hypersexuality in Parkinson's disease

Parkinson's disease (PD) is associated with numerous non-motor phenomena, among which sexual dysfunction and abnormal sexual behavior play a major role, as they are often associated with deterioration in quality of life and satisfaction in their partnership for the patient as well as their partner. Male PD patients suffer from erectile dysfunction, premature or delayed ejaculation and loss of libido, whereas female patients complain of decreased libido, insufficient vaginal lubrication and dyspareunia. Adjustment of medication ameliorates inhibiting motor symptoms. PDE-5-inhibitors are effective in treating erectile dysfunction in PD. Up to 10% of PD patients suffer from hypersexuality under medical treatment for PD, which is a disabling feature for both the patient and partner, and can even become a matter of criminal law. Treating physicians, above all neurologists, have to raise awareness of these symptoms and side effects of treatment, and pro-actively inquire sexual abnormalities in PD patients to enable early intervention.