Sexual dysfunction in Parkinson's disease

Meco, Giuseppe; Rubino, Alfonso; Caravona, N.; Valente, Marcella

doi:10.1016/j.parkreldis.2007.10.008

Cited by 83 publications

(65 citation statements)

References 67 publications

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“…Of note, autopsybased investigations have demonstrated the existence of PD-related lesions in these areas. 31 In patients with PD, impairment of autonomic nervous system controlling EF, physical limitations and emotional changes are also contributory factors for developing psychogenic and neurogenic ED.…”

Section: Discussionmentioning

confidence: 99%

“…6 However, other contributory factors, such as age, associated comorbidities, personal relationships, loss of self-esteem, sleep disturbances, depression and drug therapy should also be considered. 7 Development of ED during the course of PD greatly affects patients' quality of life (QOL) and can take a serious psychological toll. 8 Despite the high prevalence and disabling effect of ED in PD, it is still one of the most poorly investigated aspects of the disease.…”

Section: Introductionmentioning

confidence: 99%

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Safety and efficacy of sildenafil citrate in the treatment of Parkinson-emergent erectile dysfunction: a double-blind, placebo-controlled, randomized study

Safarinejad¹,

Taghva

Shekarchi

et al. 2010

Int J Impot Res

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Parkinson's disease (PD) is one of the most commonly occurring neurodegenerative disorders, with lifetime incidence between 1 and 2% among people older than 65 years. ED is one of the more disabling and poorly addressed aspects of PD. The purpose of this study was to assess the efficacy and safety of sildenafil citrate in Parkinson-emergent ED. Sexual function of participants was assessed using responses to the 15-question International Index of Erectile Function (IIEF), Sexual Encounter Profile (SEP) diary questions 2 and 3, Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire and a Global Efficacy Question 'Has the treatment you have been taking over the study period improved your erections?' This randomized, double-blind, placebocontrolled study, comprised a screening period of at least 1 month, a placebo-lead in period of 1 week and treatment period. Two hundred thirty-six patients entered the trial. These patients had mild-to-moderate PD (stages I-III Hoehn-Yahr) and were experiencing Parkinson-emergent neurogenic ED. They were randomized to receive 100 mg sildenafil on demand 1 h before sexual activity (group 1, n ¼ 118), or similar regimen of placebo (group 2, n ¼ 118). Patients were instructed to use at least 24 doses/attempts at home. At the end of the trial, differences between sildenafil and placebo groups were significant for the IIEF erectile function (EF) score (22.6 ± 4.6 vs 14.8 ± 4.2, P ¼ 0.01), for percent Global Efficacy Question 'Yes' responses (68.1±4.6 vs 12.2±3.2, P ¼ 0.001), for SEP2 'Yes' responses (68.1±4.2 vs 32.5±2.2, P ¼ 0.003), for SEP3 'Yes' responses (75.9±5.4 vs 33.5 ± 4.4, P ¼ 0.004) and for mean EDITS score (69.8 ± 4.2 vs 13.0 ± 2.7, P ¼ 0.004). A normal EF domain score (X26) at end point was achieved by 56.9 and 8.7% of the patients in the sildenafil and placebo groups, respectively (P ¼ 0.001). Sildenafil can be considered as an effective treatment in patients with Parkinson-emergent ED.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of sildenafil citrate in the treatment of Parkinson-emergent erectile dysfunction: a double-blind, placebo-controlled, randomized study

Safarinejad¹,

Taghva

Shekarchi

et al. 2010

Int J Impot Res

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“…4 Disorders of the brain structure or function are mostly associated with disturbances in male sexual behavior. 5,6 Recent studies showed the negative effect of MPs on the male genital system, both in animals 7,8 and in human subjects. 9 All these studies dealt only with the influence of MPs on testicular structure and function 7,[9][10][11] and male accessory genital organs.…”

Section: Introductionmentioning

confidence: 99%

Effects of exposure to a mobile phone on sexual behavior in adult male rabbit: an observational study

Salama

Kishimoto²,

Kanayama³

et al. 2009

Int J Impot Res

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The accumulating effects of exposure to electromagnetic radiation emitted by a conventional mobile phone (MP) on male sexual behaviour have not yet been analyzed. Therefore, we studied these effects in 18 male rabbits that were randomly divided into phone and control groups. Six female teasers were taken successively to the male's cage and the copulatory behavior was recorded. Serum total testosterone, dopamine and cortisol were evaluated. The animals of the phone group were exposed to MPs (800 MHz) in a standby position for 8 h daily for 12 weeks. At the end of the study, the copulatory behavior and hormonal assays were re-evaluated. Mounts without ejaculation were the main mounts in the phone group and its duration and frequency increased significantly compared with the controls, whereas the reverse was observed in its mounts with ejaculation. Ejaculation frequency dropped significantly, biting/grasping against teasers increased notably and mounting latency in accumulated means from the first to the fourth teasers were noted in the phone group. The hormonal assays did not show any significant differences between the study groups. Therefore, the pulsed radiofrequency emitted by a conventional MP, which was kept on a standby position, could affect the sexual behavior in the rabbit.

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“…Dysautonomia manifests as erectile dysfunction (ED) but also as reduced genital sensitivity and lubrication and difficulties reaching orgasm. 5 Controlled clinical trials were available only for ED in PD. One Class II study evaluated the efficacy of sildenafil citrate (Viagra ® ) in treating ED in 12 patients with PD.…”

Section: What Treatments Are Effective For Sexual Dysfunction In Pd?mentioning

confidence: 99%

Practice Parameter: Treatment of nonmotor symptoms of Parkinson disease [RETIRED]

et al. 2010

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Objective: Nonmotor symptoms (sleep dysfunction, sensory symptoms, autonomic dysfunction, mood disorders, and cognitive abnormalities) in Parkinson disease (PD) are a major cause of morbidity, yet are often underrecognized. This evidence-based practice parameter evaluates treatment options for the nonmotor symptoms of PD. Articles pertaining to cognitive and mood dysfunction in PD, as well as treatment of sialorrhea with botulinum toxin, were previously reviewed as part of American Academy of Neurology practice parameters and were not included here. Methods:A literature search of MEDLINE, EMBASE, and Science Citation Index was performed to identify clinical trials in patients with nonmotor symptoms of PD published between 1966 and August 2008. Articles were classified according to a 4-tiered level of evidence scheme and recommendations were based on the level of evidence. Results and Recommendations:Sildenafil citrate (50 mg) may be considered to treat erectile dysfunction in patients with Parkinson disease (PD) (Level C). Macrogol (polyethylene glycol) may be considered to treat constipation in patients with PD (Level C). The use of levodopa/carbidopa probably decreases the frequency of spontaneous nighttime leg movements, and should be considered to treat periodic limb movements of sleep in patients with PD (Level B). There is insufficient evidence to support or refute specific treatments for urinary incontinence, orthostatic hypotension, and anxiety (Level U). Future research should include concerted and interdisciplinary efforts toward finding treatments for nonmotor symptoms of PD. Neurology The Quality Standards Subcommittee (QSS) of the American Academy of Neurology (AAN) develops scientifically sound, clinically relevant practice parameters to aid in the practice of neurology. This article evaluates treatment options for nonmotor symptoms of Parkinson disease (PD).While PD is considered a disorder characterized by motor symptoms, nonmotor symptoms are an integral part of this syndrome. These symptoms can be as troublesome as motor symptoms and impact activities of daily living, though they are often underrecognized by health care professionals.1,2 The nonmotor symptoms reviewed for this guideline were autonomic dysfunction (gastrointestinal disorders, orthostatic hypotension, sexual dysfunction, urinary incontinence), sleep disorders (restless legs syndrome, periodic limb movements of sleep, excessive daytime somnolence, insomnia, REM sleep behavior disorder), fatigue, and anxiety. Articles pertaining to cognitive and mood dysfunction in PD, as well as treatment of sialorrhea with botulinum toxin, were reviewed as part of previous AAN practice parameters 3,4 and were not included here.

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Sexual dysfunction in Parkinson's disease

Cited by 83 publications

References 67 publications

Safety and efficacy of sildenafil citrate in the treatment of Parkinson-emergent erectile dysfunction: a double-blind, placebo-controlled, randomized study

Safety and efficacy of sildenafil citrate in the treatment of Parkinson-emergent erectile dysfunction: a double-blind, placebo-controlled, randomized study

Effects of exposure to a mobile phone on sexual behavior in adult male rabbit: an observational study

Practice Parameter: Treatment of nonmotor symptoms of Parkinson disease [RETIRED]

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