Yes, yes - this is an embarrassing topic. It is not pleasant to write about it and it is not pleasant to talk about it. But sex and sexuality are an integral part of each of us, including people dealing with Parkinson's disease.

a question:

I am a Parkinson's patient who, like others, faces problems with my sex drive. Every user of erectile dysfunction drugs (such as Cialis, Levitra and Viagra) is surely familiar with the changes required from both partners, and it is difficult!!! For example, go schedule the desire, and if the desire ran away then the money is gone [the business is expensive]. The money is gone, sometimes the desire also escapes, and without desire there is no "weapon". In short, you need to check how you can return the "crown to its former glory". Unfortunately, doctors often show no interest in the question of sex and make an easy life for themselves when they ignore the problem. This article deals with the specific question, How to deal with the use of erectile dysfunction drugs, and is there a chance of returning the "crown to its former state".

Answer:

True, most doctors, not only in the field of neurology, do not usually ask about problems in the sexual field, even if they are directly related to the disease or its drug treatment. The reason is not necessarily lack of interest, but a combination of lack of time and fear of embarrassing themselves and their patients in a too intimate conversation. Erectile problems arise from a combination of several factors: age (natural aging), the cooperation between the two partners in sexual relations, the quality of the relationship, the disease itself and the medications. Success in using one of the drugs for erection is achieved only if you take an appropriate dose and wait enough time for the drug to be absorbed (remember: in Parkinson's disease there is a slowdown in the rate of drug absorption and sometimes you have to wait twice as long as is recommended for a person without Parkinson's). And don't forget that The drug only works if you are in an atmosphere of sexual stimulation. In addition, it is recommended to try to have sex with the drug 8-4 times before you achieve success, even if you have to invest the price, in order to get used to it and find the appropriate waiting time. The main reason is that when a long time of problematic sex passes, there is a hidden tension in the partners in the act of love. This tension reduces the effectiveness of the stimulation and the effectiveness of the drug. It should be taken into account that maybe your problem is not an erection problem, but Traffic problem. In many Parkinson's patients I met, there was a normal erection (for example, by masturbation or manual stimulation of a partner), but as soon as the man tried to change position in order to enter the vagina, he lost the erection. In such cases, intercourse and positions must be planned differently.  Sometimes the problem is combined. You have a mild erectile problem and your partner has another sexual problem. For example, if she is menopausal and suffers from vaginal dryness. In such a case, penetration into the vagina is difficult, and then the man may lose his erection and the woman may suffer from pain during intercourse. The result is a decrease in libido in both of them and a reluctance to have sex. In such a case, the erection problem is treated in combination with the woman's dryness problem. As can be understood, the issue is complex and usually requires a careful diagnosis, which combines a medical diagnosis as well as a sexological-couple diagnosis.

Gila Bruner MPH MSW CST - director of the sexology service at the Center for Sexual Medicine,
Department of Urology, Sheba Medical Center, Tel Hashomer
Gila.bronner@sheba.health.gov.il
http://www.sheba.co.il/

To make an appointment for treatment: individual or couple 03-5305970