Management of sexual dysfunction in Parkinson’s disease

Nonmotor symptoms, among them sexual dysfunction, are common and underrecognized in patients with Parkinson disease; they play a major role in the deterioration of quality of life of patients and their partners. Loss of desire and dissatisfaction with their sexual life is encountered in both genders. Hypersexuality (HS), erectile dysfunction and problems with ejaculation are found in male patients, and loss of lubrication and involuntary urination during sex are found in female patients. Tremor, hypomimia, muscle rigidity, bradykinesia, ‘clumsiness’ in fine motor control, dyskinesias, hypersalivation and sweating may interfere with sexual function. Optimal dopaminergic treatment should facilitate sexual encounters of the couple. Appropriate counselling diminishes some of the problems (reluctance to engage in sex, problems with ejaculation, lubrication and urinary incontinence). Treatment of erectile dysfunction with sildenafil and apomorphine is evidence based. HS or compulsive sexual behaviour are side effects of dopaminergic therapy, particularly by dopaminergic agonists, and should be treated primarily by diminishing their dose. Neurologists should actively investigate sexual dysfunction in their Parkinsonian patients and offer treatment, optimally within a multidisciplinary team, where a dedicated professional would deal with sexual counselling.

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Bupropion as a Treatment for Sexual Dysfunction Among Chronic Kidney Disease Patients

ACTA MEDICA IRANICA ◽

10.18502/acta.v57i5.1869 ◽

2019 ◽

Author(s):

Abolfazl Ghoreishi ◽

Lila Dashtaki ◽

Bahareh Hajisalimi

Keyword(s):

Quality Of Life ◽

Chronic Kidney Disease ◽

Erectile Dysfunction ◽

Sexual Dysfunction ◽

Kidney Disease ◽

Sexual Function ◽

Total Quality ◽

Significant Difference ◽

Male Patients

Sexual dysfunction is a common complication among male patients with chronic kidney disease. Common disturbances include erectile dysfunction, decreased libido, and infertility. Sexual dysfunction is a multifactorial problem, and the treatment options are limited, it associated with lower quality of life scores in patients. Chronic kidney disease also has a critically impairing effect on the quality of life. To investigate the efficacy of bupropion on sexual dysfunction and quality of life in men with chronic kidney disease, a single-blind placebo-controlled trial was conducted. A total of 40 male patients with chronic kidney disease suffering from erectile dysfunction (Mean age 41/25±8/8) were randomly assigned to receive 10 weeks of treatment with either bupropion or placebo. Sexual function and quality of life were assessed by IIEF5 and WHOQOL-BREF questionnaires, respectively. Baseline demographic and clinical features were similar in both groups. The results showed a significant difference between the intervention and control groups in sexual function (P=0/005) and total quality of life (P=0/001); also the difference was significant in physical health (P=0/012), psychological health (P<0/001) and social relationship (P<0/001) domains. Our findings suggest that Bupropion is effective and safe for treating sexual dysfunction in men with chronic kidney disease and also could positively affect the quality of life among the patients. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(5):320-327.

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Acceptance of the disease and sexual functions of patients with heart failure

European Journal of Cardiovascular Nursing ◽

10.1177/1474515120944518 ◽

2020 ◽

pp. 147451512094451

Author(s):

Alicja Wiśnicka ◽

Izabella Uchmanowicz ◽

Dorota Dyjakon ◽

Ewelina Cichoń ◽

Remigiusz Szczepanowski ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Sexual Functioning ◽

Important Determinant ◽

Sexual Life ◽

Patients With Heart Failure ◽

Sexual Counselling ◽

Male Patients ◽

Acceptance Of Illness

Background: Sexual activity is an important element of quality of life for many individuals suffering from heart failure. Aims: The study investigated the influence of disease acceptance on sexual function in a population of male patients with chronic heart failure. Methods: The study included 80 patients with chronic heart failure (mean age 63.3±9.2 years) who filled in the Mell–Krat Scale questionnaire to evaluate sexual needs and reactions. We also used the International Index of Erection Function (IIEF-5) inventory and the Acceptance of Illness Scale (AIS). Results: The study showed that the acceptance of the illness was positively associated with all of the Mell–Krat components such as sexual need, F = (3.27), frequency of intercourse, F = (2.46), position and technique, F = (1.88). Also, according to the IIEF-5 questionnaire, 84.42% of respondents had erectile dysfunction. Taken together these indicated that psychological adjustments such as acceptance of disease increase quality of all aspects of sexual functions in heart failure patients, including their erectile functions. Conclusions: Our findings suggest that psychological adjustments to feelings of loss associated with the onset of heart failure disease is the important determinant of quality of sexual life among male adults. Our research implicates that effects of AIS on sexual functioning give reasonable information to tailor sexual counselling for males suffering from heart failure.

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Erectile dysfunction and antipsychotics

European Psychiatry ◽

10.1016/s0924-9338(11)73247-3 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1543-1543

Author(s):

F. Fifani ◽

Y. Otheman ◽

M. Outarahout ◽

A. Ouanass

Keyword(s):

Quality Of Life ◽

Erectile Dysfunction ◽

Side Effects ◽

Sexual Dysfunction ◽

Fluphenazine Decanoate ◽

Antipsychotic Medications ◽

Sexual Side Effects ◽

Male Patients ◽

Classification Evaluation

Sexual side effects associated with antipsychotic medications constitute an understudied set of side effects that diminish a patient's quality of life, and lead to noncompliance with treatment. Male patients frequently report disturbances in erectile and ejaculatory functioning, as well as changes in libido. The capacity to trigger sexual dysfunction differs from one antipsychotic to another. Clinicians prescribing antipsychotic medications should be familiar with the classification, evaluation and treatment of these side effects. The purpose of this study is to assess the occurrence of erectile dysfunction for 5 classes of antipsychotics (Haloperidol, Risperidone, Olanzapine, Amisulpride and Fluphenazine decanoate) in a population of 120 patients, using the International Index of Erectile Dysfunction (IIEF 5).

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Faculty Opinions recommendation of Improvement in quality of sexual life in female partners of men with erectile dysfunction treated with sildenafil citrate: findings of the Index of Sexual Life (ISL) in a couple study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1161186.621663 ◽

2009 ◽

Author(s):

Stanley Althof ◽

Rachel Needle

Keyword(s):

Erectile Dysfunction ◽

Sildenafil Citrate ◽

Sexual Life ◽

Female Partners

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PENGARUH SINDROMA DEPRESI TERHADAP DISFUNGSI EREKSI

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.1.2.2009.818 ◽

2013 ◽

Vol 1 (2) ◽

Author(s):

Andre Hutagalung ◽

Christoffel Elim ◽

Herdy Munayang

Keyword(s):

Quality Of Life ◽

Erectile Dysfunction ◽

Sexual Function ◽

Key Words ◽

Sexual Intercourse ◽

Social Process ◽

Sexual Life ◽

Sexual Stimulus ◽

Physical Diseases

Abstract: Normal sexual function is a bio-psycho-social process which is significantly related to the quality of life (QOL). Any disturbance in one of the components can be a disaster in sexual life. Erectile dysfunction is a disability to get an erection or to maintain the erection well enough for a sexual intercourse, which persists or recurs at least three months conse-cutively due to either psychogenic or organic disturbances, or both. Some psychogenic dis-turbances especially depression, anxiety, and relational distress, play some important roles in ED. Besides that, aging, low testoteron level, physical diseases, and some certain medicines have to be included. Key words: erection, erectile dysfunction, sexual stimulus, depression. Abstract: Fungsi seksual yang normal merupakan suatu proses biopsikososial yang berkaitan langsung dengan kualitas hidup. Adanya gangguan pada salah satu komponen dapat menjadi malapetaka bagi kehidupan seksual. Disfungsi ereksi dapat dedefinisikan sebagai suatu keti-dakmampuan untuk ereksi atau mempertahankan ereksi yang cukup untuk melakukan hu-bungan seksual yang memuaskan, yang menetap atau berulang paling tidak selama tiga bulan berturut-turut. Gangguan psikogenik khususnya sindroma depresi, ankietas, dan distres relasional berperan penting dalam hal terjadinya disfungsi ereksi. Disamping itu usia lanjut, rendahnya kadar testoteron, penyakit fisik, dan beberapa jenis obat perlu diperhitungkan. Kata kunci: fisiologi ereksi, disfungsi ereksi, stimulus seksual, depresi.

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SEXUAL DISORDERS AFTER HEART TRANSPLANT

Wiadomości Lekarskie ◽

10.36740/wlek202010133 ◽

2020 ◽

Vol 73 (10) ◽

pp. 2277-2281

Author(s):

Kamila Fuczyło ◽

Magdalena Piegza ◽

Robert Pudlo

Keyword(s):

Quality Of Life ◽

Erectile Dysfunction ◽

Sexual Dysfunction ◽

Heart Transplantation ◽

Heart Transplant ◽

Sexual Disorders ◽

State Of Health ◽

Review Of The Literature ◽

Pubmed Database

The aim: To systematize and bring the reader closer to knowledge about the occurrence of sexual disorders in people after heart transplantation based on available bibliography. Material and methods: A review of the literature on this topic from the last 30 years made with using the PubMed database, using a total of 17 articles. Conclusions: The incidence of sexual dysfunction (SD) is higher in heart recipients than in the general population and erectile dysfunction is the most common. When the symptoms of dysfunction occur before the transplant – they do not improve, rather they get worse, which reduces the improvement in the quality of life of these patients compared to patients without sexual dysfunction. Improvement in quality of life is observed in patients with SD after heart transplantation, but not as pronounced as in subjects without sexual dysfunction. Some patients notice an increase in libido, with the genital response being insufficient or completely disappearing, which results in a decrease in the quality of relationships between partners and a deterioration in the quality of life. The cause of SD in heart recipients is unclear, but it is associated with the type of immunosuppression used, the level of sexual activity and the state of health of patients prior to transplantation. Nowadays patients after ortotrophic heart transplant live longer and their quality of life improves, but not in sexual terms. The articles concerned almost exclusively men, that is why the topic requires exploration in subsequent research.

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Drugs

ESC CardioMed ◽

10.1093/med/9780198784906.003.0249 ◽

2018 ◽

pp. 1030-1035

Author(s):

Mike Kirby ◽

Jonny Coxon

Keyword(s):

Quality Of Life ◽

Cardiovascular Disease ◽

Erectile Dysfunction ◽

Negative Effects ◽

Phosphodiesterase Type 5 Inhibitors ◽

Cardiac Condition ◽

Male Patients ◽

Phosphodiesterase Type ◽

The Impact

It should not be presumed that male patients with cardiovascular disease are less sexually active than others, but they are more likely to have erectile dysfunction. It is therefore crucial to consider the impact on sexual function of medications commonly used to treat cardiovascular disease, because negative effects on erectile dysfunction can lead to problems with compliance and quality of life. Cardiovascular implications of phosphodiesterase type 5 inhibitors used to treat erectile dysfunction should be borne in mind. Effective treatment of the cardiac condition should always take priority.

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P0838HYPERPROLACTINEMIA IN CKD PATIENTS AND ITS ASSOCIATION WITH STRENGHT, SEXUAL DYSFUNCTION ANS QUALITY OF LIFE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0838 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Pedro do Valle Teichman ◽

Gabrielle Zanotto de Oliveira ◽

Samile Sallaberry Echeverria Silveira ◽

Carlos Alberto Angarita Jaime ◽

Mariana Lopes De Castro ◽

...

Keyword(s):

Quality Of Life ◽

Sexual Dysfunction ◽

Handgrip Strength ◽

Stage Iv ◽

Free Testosterone ◽

Serum Prolactin ◽

Hormone Production ◽

Ckd Stage ◽

Male Patients

Abstract Background and Aims Hyperprolactinemia is a hormonal disorder associated with many diseases, including chronic kidney disease (CKD). Some studies have shown that serum prolactin (PRL) levels increase as CKD progresses, due to decreased renal clearance and increased production. This prolactin retention leads to inhibition of gonadotropic hormone production, and testosterone deficiency in male patients with CKD. Thus, this study aimed to evaluate PRL levels in male patients with different stages of CKD and its association with clinical and laboratory characteristics, strength, sexual dysfunction, and quality of life. Method This is a transversal study conducted in a tertiary hospital in southern Brazil. Patients with CKD stage IV and V were included and divided into three groups: 1) stage IV; 2) non-dialysis-dependent stage V and; 3) dialysis-dependent stage V (VD). Patients with prescribed hormone therapy were excluded. PRL, creatinine, testosterone, estradiol, albumin, SHBG, LH, and FSH levels were measured. Free testosterone was estimated by the Vermeulen equation. Patients were also evaluated for strength and musculoskeletal function through the “handgrip strength” test. For evaluation of the quality of life and sexual dysfunction, validated questionnaires were applied: AMS (Aging Male's Symptoms Scale), ADAM (Androgen Deficiency in the Aging Male) and SF-36 Health. Results In this study, 164 patients were included (IV=75; V=41; VD=48). The mean age was 64 [55-71] years and BMI 26,9 [23,3-30,04] kg/m2. The dialysis-dependent group had higher prevalence of hyperprolactinemia (22,6% vs. 49% vs. 66%, p<0,001), higher PRL (13,4 vs. 19,43 vs. 26,13, p<0,001) and estradiol (25,6 vs. 24,4 vs. 30,5, p=0,041). PRL levels were positive correlated with CKD stage (rs=0,482, p<0,001) and creatinine (rs=0,467, p<0,001) and negative correlated with testosterone (rs=-0,286, p<0,001) and free testosterone levels (rs=-0,307, p<0,001). There was no difference in PRL levels between hemodialysis and peritoneal dialysis (p=1,000). Analyzes related to the association of PRL levels with strength, quality of life, and sexual dysfunction are still being analyzed. Conclusion Hyperprolactinemia is associated with the severity of CKD, with a higher prevalence in dialysis patients. The relation of PRL levels with strength, quality of life, and sexual dysfunction are being evaluated.

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