Postural instability, the absence of sexual intercourse in the past month, and loss of libido are predictors of sexual dysfunction in Parkinson’s disease

• SD is a common non-motor manifestation of PD affecting 81.6% of patients in our study.
• Premature ejaculation and orgasmic dissatisfaction are the most distressing sexual problems in males and females respectively.
• SD in PD correlates with greater disease severity, and depression.
• Three predictors of SD in PD include postural instability, absence of SI in the past month, and loss of libido.

ObjectiveTo determine the prevalence and predictors of sexual dysfunction (SD) in Parkinson's disease (PD) patients.BackgroundAssessments of SD in the professional literature is limited. Understanding the predictors of SD can help physicians focus on this problem in vulnerable patients.MethodA total of 60 PD patients and 60 controls answered the Arizona Sexual Experiences Scale-Thai Version (ASEX-Thai) and the Hamilton Depression Rating Scale (HAMD) questionnaires, and were asked on 3 additional sets of questions about premature ejaculation (PE), dyspareunia, and hypersexual disorders.ResultThe prevalence of SD in PD patients and controls was 81.6% and 48.3% respectively (p < 0.05). PD patients had lower BMI, lower uric acid level, higher HAMD score and had sexual intercourse (SI) less frequently. SD correlated with greater disease severity and depression. The most distressing problem in male patients was PE (51.4%) and orgasmic dissatisfaction (76%) for female patients. Logistic regression analysis found 3 factors were related to SD: no SI in the past month (p < 0.001), postural instability (PI) (p = 0.028), and HAMD item 14 (p = 0.021), predicting SD with the OR of 12.2, 5.5, and 5.0 respectively.ConclusionsSD in PD is common and usually occurs with depression. Absence of SI in the past month, PI, and loss of libido are predictors of SD in PD. A simple and quick screening of SD can be routinely performed by inquiring patients about the frequency of SI and the examination of the pull test. Detailed assessment of sexual functioning and depression may guide physicians in proper management.