Prevalence of hypersexual behavior in Parkinson’s disease patients: Not restricted to males and dopamine agonist use

Abstract

This study investigates the prevalence and demographic characteristics of hypersexuality in Parkinson’s disease (PD). Impulse control disorders in PD patients have been associated with dopamine agonist therapy. Moreover, hypersexuality and pathological gambling have been associated with males, while females may be inherently thought to be more likely to participate in compulsive shopping and binge-eating behaviors. In this study, a screening mail-in survey was sent to all PD patients at a single Movement Disorders Center. One hundred forty one of 400 (35.3%) research packets were returned completed. Fifteen of 141 patients met initial screening criteria for hypersexual behavior. After detailed interview, only 6/141 (4.3%) of PD patients met criteria for pathologic hypersexual behavior. These behaviors included: compulsive masturbation, prostitution, and paraphilias. Patients with a younger age of PD onset were more likely to exhibit hypersexual behavior. Unlike previous report, no significant association was found between hypersexuality and gender or dopamine agonist use. Rather, this study suggests that physicians should be vigilant for hypersexual behavior in all PD patients, regardless of gender and PD medication regimen. Ultimately, given the innate sensitivity of the topic and survey limitations, it is very likely that hypersexual behavior in our cohort, as it is in the general PD population, has been under-reported.

Measurement of sexual disinhibition in dementia: A systematic review

“…For example, one domain of measurement that emerged was hypersexuality. This symptom has been suggested to have distinct etiological and neural correlates (eg, in Parkinson disease), underscoring the importance of collecting diagnostic information in addition to SD behavior data. The emergence of lewd/aberrant sexual behavior as a domain of measure also raises several important considerations.…”

Compulsive sexual behavior: A review of the literature

“…Certain neurological disorders can cause an individual to act inappropriately and possibly cause hypersexuality as a result. Some of the most common examples are Alzheimer’s Disease (sexual disinhibition due to the effects of the disease on the frontal and temporal lobes, with a prevalence of 4.3%–9.0% of patients; Cooper et al, 2009 ; Callesen, Weintraub, Damholdt & Møller, 2014 ), Pick’s Disease (impairs the regulation of socially acceptable behaviors) and Kleine-Levin Syndrome (causing hypersomnia, which can cause abnormal behavior such as hypersexuality) ( Callesen et al, 2014 ; Cooper et al, 2009 ; Dhikav, Anand & Aggarwal, 2007 ; Gadoth, Kesler, Vainstein, Peled & Lavie, 2001 ; Mendez, Selwood, Mastri & Frey, 1993 ). In addition, certain types of medications or illicit drugs can also cause an increased sexual drive such as dopamine agonists used to treat Parkinson’s disease or cocaine, GHB, and methamphetamine ( Smith, 2007 ).…”

The prevalence and clinical characteristics of hypersexuality in patients with Parkinson's disease following dopaminergic therapy: A systematic literature review

“…In PD, early prevalence estimates have shown considerable disparity, ranging from 1.7% to 8.8% [14][15][16][17]. However, most epidemiological studies have focussed on convenience samples of patients recruited at single sites, therefore providing limited evidence.…”