Parkinson and Sexuality

Sexual dysfunctions (SD) are the most systematically neglected non-motor symptoms in Parkinson’s disease (PD). PD is a neurodegenerative, chronic, and progressive disorder, with two leading features: (1) an accumulation of α-synuclein aggregates inside the neuronal cells and (2) a neuronal degeneration at the pars-compacta level of the black substance of the ventral midbrain, with a progressive destruction of motor neurons in the basal ganglia. It becomes clinically evident when 70–80% of motor neurons have already been destroyed. The aim of this chapters is threefold: (1) analyze the key impact of PD on both male and female sexual function; (2) describe the impact of PD treatments, and specifically of L-Dopa, on male sexuality, focusing on impulse control disorders, namely hypersexuality, as women seem to be less affected by this drug; and (3) stress the importance of menopausal hormone therapy (MHT) in reducing the onset and progression of PD in women, while attenuating all the menopausal symptoms that can further burden the female life and sexual experience. Women’s wording is reported to highlight the PD impact on their sexuality. Key clinical recommendations will be finally discussed briefly.