Sexual Health

Role of Sexual Health Professional

"Sex therapy" is effective for adults of any age, gender, or sexual orientation. Through sex therapy, one can address sexual problems and concerns about sexual function, sexual feelings, and intimate relationships - either in individual or couple sessions. Sex therapy is usually provided by psychologists, social workers, physicians, or other licensed therapists, who have been formally trained and mentored. A subgroup of these professionals focuses on disease-related sexual problems and has experience in medical sexology/sexual medicine. While this therapy can be specifically tailored to the needs of Parkinson's patients, this approach is equally helpful for people with other movement disorders. 

People with Parkinson’s Disease (PwPD) and their partners experience significant sexual changes in the course of the disease. Common problems are: 

• a desire disorder ('too low,' 'too high,' or too much difference between the partners) 
• erectile difficulties, premature ejaculation, or trouble reaching orgasm 
• pain during sexual activity and sexual dissatisfaction. 

These changes can be part of the natural progression of the disease, the sexual side effects of PD medication, or both. 

Natural age-related sexual changes in men and women, as well as myths about sexuality, may add even more distress to one’s sexual life. In most couples with PD, the disease itself or treatments can negatively influence sexual function, sexual identity, and sexual relationships, resulting in diminished intimacy and quality of life. The overall goal of sex therapy is re-establishing pleasure and satisfaction rather than achieving perfect genital response. 

The movement disorders sexual health professional can assist PwPs and their partners by: 

• Providing information on sexual function and dysfunction 
• Providing information on how Parkinson's disease affects the individual’s and the couple’s sexuality 
• Dispelling common myths and describing how individual sexual preferences differ 
• Discussing ethnic, cultural, and religious influences 
• Different treatment approaches include learning to give and receive enjoyable touches, reducing stress and improving relaxation, relationship therapy, cognitive restructuring, communication skills, sexual dysfunction medications, and other tools. 

Sexual health professionals usually work in an interdisciplinary team where they also provide a range of services to health care professionals, such as: 

• Training in sexual communications in the medical setting 
• Help in accessing sexual health provider networks 
• Providing brief consultations in the clinical setting 
• Management strategies 

One of the sexual health benchmarks is the belief that every person is entitled to realize one's sexual potential, both emotionally and physically, and to share intimate thoughts, feelings, and activities with a partner. In our experience, PwPs are regularly deprived of this right due to barriers about how to ask for counseling as well as healthcare professional barriers: discomfort in introducing, openly discussing, and referring PwP to qualified therapists. 

Contributed by Gila Bronner, MPH, MSW (Sex Therapist) and Woet Gianotten, MD (Psychotherapist; consultant in rehabilitation sexology) 2013; Maintained by Health Professional SIG.

From the Health Professionals Special Interest Group