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Sexual dysfunction in male patients with Parkinson’s disease: related factors and impact on quality of life

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Abstract

Background

Sexual dysfunction (SD) is a common, yet under-reported, non-motor symptom (NMS) of Parkinson’s disease (PD). The present study investigated the sexual functions in PD male patients, its correlation with motor and other NMSs, and their impact on health-related quality of life (HRQoL).

Methods

The sexual functions of 40 PD male patients were assessed using the International Index of Erectile Function (IIEF) and compared to 25 healthy age-matched controls. Patients were evaluated using the NMS Scale (NMSS) and the Arabic version of the Parkinson’s-Disease Questionnaire (PDQ-39). We compared the sexual functions of younger (≤ 55 years) and elder (> 55 years) males and tested the correlations between sexual functions and motor, other NMSs, and HRQoL.

Results

Seventy percent of PD male patients reported erectile dysfunction. They showed significantly worse total (p < 0.001) and subscores of IIEF, compared to healthy controls. The total IIEF was inversely correlated to age of patients (p = 0.013), age at onset (p = 0.043), total, cognitive/mood, gastrointestinal and urinary domains of NMSS, and the cognitive domain of PDQ-39 (p = 0.013). Age was the main predictor (ß = − 0.581, p = 0.006) of SD. Elder patients showed worse sexual functions, stronger correlations to other NMSs, and more impact on HRQoL than younger patients.

Conclusion

Sexual functions are worse among PD male patients with age as the main predictor. SD was associated with worse cognitive/mood and urinary domains of NMSS and has a negative impact on the patients’ HRQoL among elder males.

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Abbreviations

ADL:

activities of daily living

EF:

erectile function

HRQoL:

health-related quality of life

IIEF:

International Index of Erectile Function

IS:

intercourse satisfaction

NMSS:

Non-Motor Symptoms Scale

OF:

orgasmic function

OS:

overall satisfaction

PD:

Parkinson’s disease

PDQ-39:

39-item Parkinson’s Disease Questionnaire

UPDRS:

Unified Parkinson’s Disease Rating Scale

References

  1. Poewe W et al (2017) Parkinson disease. Nat Rev Dis Primers 3:17013

    PubMed  Google Scholar 

  2. Chaudhuri KR, Sauerbier A, Rojo JM, Sethi K, Schapira AH, Brown RG, Antonini A, Stocchi F, Odin P, Bhattacharya K, Tsuboi Y, Abe K, Rizos A, Rodriguez-Blazquez C, Martinez-Martin P (2015) The burden of non-motor symptoms in Parkinson’s disease using a self-completed non-motor questionnaire: a simple grading system. Parkinsonism Relat Disord 21(3):287–291

    PubMed  Google Scholar 

  3. Shalash AS et al (2018) Non-motor symptoms as predictors of quality of life in Egyptian patients with Parkinson’s disease: a cross-sectional study using a culturally adapted 39-item Parkinson’s Disease Questionnaire. Front Neurol 9:357

    PubMed  PubMed Central  Google Scholar 

  4. Ozcan T et al (2015) The relation of sexual dysfunction to depression and anxiety in patients with Parkinson’s disease. Acta Neuropsychiatr 27(1):33–37

    PubMed  Google Scholar 

  5. Ferrucci R, Panzeri M, Ronconi L, Ardolino G, Cogiamanian F, Barbieri S, Barone P, Bertolasi L, Padovani A, Priori A (2016) Abnormal sexuality in Parkinson’s disease: fact or fancy? J Neurol Sci 369:5–10

    PubMed  Google Scholar 

  6. Bronner G, Royter V, Korczyn AD, Giladi N (2004) Sexual dysfunction in Parkinson’s disease. J Sex Marital Ther 30(2):95–105

    PubMed  Google Scholar 

  7. Sakakibara R, Shinotoh H, Uchiyama T, Sakuma M, Kashiwado M, Yoshiyama M, Hattori T (2001) Questionnaire-based assessment of pelvic organ dysfunction in Parkinson’s disease. Auton Neurosci 92(1–2):76–85

    CAS  PubMed  Google Scholar 

  8. Papatsoris AG, Deliveliotis C, Singer C, Papapetropoulos S (2006) Erectile dysfunction in Parkinson’s disease. Urology 67(3):447–451

    CAS  PubMed  Google Scholar 

  9. Roumiguie M et al (2011) Assessment of sexual function in men with idiopathic Parkinson’s disease using the iInternational Index of Erectile Dysfunction (IIEF-15). Prog Urol 21(1):67–71

    CAS  PubMed  Google Scholar 

  10. Farhadi F et al (2017) Sexual dimorphism in Parkinson’s disease: differences in clinical manifestations, quality of life and psychosocial functioning between males and females. Neuropsychiatr Dis Treat 13:329–338

    PubMed  PubMed Central  Google Scholar 

  11. Buhmann C et al (2017) The impact of Parkinson disease on patients’ sexuality and relationship. J Neural Transm (Vienna) 124(8):983–996

    CAS  Google Scholar 

  12. Gao X, Chen H, Schwarzschild MA, Glasser DB, Logroscino G, Rimm EB, Ascherio A (2007) Erectile function and risk of Parkinson’s disease. Am J Epidemiol 166(12):1446–1450

    PubMed  PubMed Central  Google Scholar 

  13. Yang Y et al (2017) Relationship between erectile dysfunction, comorbidity, and Parkinson’s disease: evidence from a population-based longitudinal study. J Clin Neurol 13(3):250–258

    PubMed  PubMed Central  Google Scholar 

  14. Hughes AJ et al (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55(3):181–184

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE (2010) Systematic review of levodopa dose equivalency reporting in Parkinson’s disease. Mov Disord 25(15):2649–2653

    PubMed  Google Scholar 

  16. Chaudhuri KR et al (2007) The metric properties of a novel non-motor symptoms scale for Parkinson’s disease: results from an international pilot study. Mov Disord 22(13):1901–1911

    PubMed  Google Scholar 

  17. Shamloul R, Ghanem H, Abou-zeid A (2004) Validity of the Arabic version of the sexual health inventory for men among Egyptians. Int J Impot Res 16(5):452–455

  18. Bronner G, Korczyn AD (2018) The role of sex therapy in the management of patients with Parkinson’s disease. Mov Disord Clin Pract 5(1):6–13

    PubMed  Google Scholar 

  19. Kotkova P, Weiss P (2013) Psychiatric factors related to sexual functioning in patients with Parkinson’s disease. Clin Neurol Neurosurg 115(4):419–424

    PubMed  Google Scholar 

  20. Okun MS, McDonald WM, DeLong MR (2002) Refractory nonmotor symptoms in male patients with Parkinson disease due to testosterone deficiency: a common unrecognized comorbidity. Arch Neurol 59(5):807–811

    PubMed  Google Scholar 

  21. Goldstein DS (2003) Dysautonomia in Parkinson’s disease: neurocardiological abnormalities. Lancet Neurol 2(11):669–676

    PubMed  Google Scholar 

  22. Reid WG et al (2011) Dementia in Parkinson’s disease: a 20-year neuropsychological study (Sydney Multicentre Study). J Neurol Neurosurg Psychiatry 82(9):1033–1037

    CAS  PubMed  Google Scholar 

  23. Kummer A, Cardoso F, Teixeira AL (2009) Loss of libido in Parkinson’s disease. J Sex Med 6(4):1024–1031

    PubMed  Google Scholar 

  24. Derouesné C, Guigot J, Chermat V, Winchester N, Lacomblez L (1996) Sexual behavioral changes in Alzheimer disease. Alzheimer Dis Assoc Disord 10(2):86–92

    PubMed  Google Scholar 

  25. Tsai S-J et al (1999) Inappropriate sexual behaviors in dementia: a preliminary report. Alzheimer Dis Assoc Disord 13(1):60–62

    CAS  PubMed  Google Scholar 

  26. Cannas A, Solla P, Floris GL, Serra G, Tacconi P, Marrosu MG (2007) Aberrant sexual behaviours in Parkinson’s disease during dopaminergic treatment. J Neurol 254(1):110–112

    PubMed  Google Scholar 

  27. Harvey N (1988) Serial cognitive profiles in levodopa-induced hypersexuality. Br J Psychiatry 153(6):833–836

    CAS  PubMed  Google Scholar 

  28. Bronner G, Cohen OS, Yahalom G, Kozlova E, Orlev Y, Molshatzki N, Strauss H, Hassin-Baer S (2014) Correlates of quality of sexual life in male and female patients with Parkinson disease and their partners. Parkinsonism Relat Disord 20(10):1085–1088

    PubMed  Google Scholar 

  29. Moisan F et al (2016) Parkinson disease male-to-female ratios increase with age: French nationwide study and meta-analysis. J Neurol Neurosurg Psychiatry 87(9):952–957

    PubMed  Google Scholar 

  30. Ozcan T et al (2016) The association between symptoms of sexual dysfunction and age at onset in Parkinson’s disease. Clin Auton Res 26(3):205–209

    PubMed  Google Scholar 

  31. Wagle KC, Carrejo MH, Tan RS (2012) The implications of increasing age on erectile dysfunction. Am J Mens Health 6(4):273–279

    PubMed  Google Scholar 

  32. Wickremaratchi MM et al (2011) The motor phenotype of Parkinson’s disease in relation to age at onset. Mov Disord 26(3):457–463

    PubMed  Google Scholar 

  33. Okun MS, DeLong M, Hanfelt J, Gearing M, Levey A (2004) Plasma testosterone levels in Alzheimer and Parkinson diseases. Neurology 62(3):411–413

  34. Celikel E, Ozel-Kizil ET, Akbostanci MC, Cevik A (2008) Assessment of sexual dysfunction in patients with Parkinson’s disease: a case-control study. Eur J Neurol 15(11):1168–1172

    CAS  PubMed  Google Scholar 

  35. Lundberg PO (2015) Approach to the male patient with sexual dysfunction. Handb Clin Neurol 130:137–142

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, Faculty of Medicine, Ain Shams University, Abbasia Square, Cairo, 11517, Egypt

    Ali Shalash, Eman Hamid & Haitham Hamdy Salem

  2. Okasha Institute of Psychiatry- Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Hanan Elrassas

  3. Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Abdelrahman Ibrahim Abushouk

Authors
  1. Ali Shalash
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  2. Eman Hamid
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  3. Hanan Elrassas
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  4. Abdelrahman Ibrahim Abushouk
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  5. Haitham Hamdy Salem
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Corresponding author

Correspondence to Ali Shalash.

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The authors declare that they have no conflicts of interest.

Ethical statement

The study was approved by the institutional Ethics Committee at the Faculty of Medicine, Ain Shams University. All subjects gave written informed consent according to the Declaration of Helsinki of 1975, as revised in 2008.

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Shalash, A., Hamid, E., Elrassas, H. et al. Sexual dysfunction in male patients with Parkinson’s disease: related factors and impact on quality of life. Neurol Sci 41, 2201–2206 (2020). https://doi.org/10.1007/s10072-020-04328-2

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  • DOI: https://doi.org/10.1007/s10072-020-04328-2

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