Sexuality is an important aspect of human existence and of intimacy in adult relationships. Its importance does not change with a diagnosis of Parkinson’s disease, although the ways in which a couple deals with their needs for intimacy often do. Changes in body appearance that take place as Parkinson’s disease progresses sometimes cause people to feel embarrassed and insecure about whether they remain sexually attractive to their partner. Sometimes the healthy partner is reluctant to initiate sexual encounters or to discuss matters of sexuality; such reluctance can create even greater self-doubt in the partner who has Parkinson’s. Partners need to be reassuring and loving to each other and to enjoy physical closeness in ways they are capable of and feel comfortable with using. It is important for partners to maintain open and honest dialogue about concerns that are fundamental to their relationship.
Issues related to interest in sex, such as diminished libido, often have both physical and emotional components. Neuromuscular symptoms such as tremors and bradykinesia can make the physical act of sexual intercourse more difficult. The disease takes a toll on the stamina and energy level of the person with Parkinson’s, and by bedtime when couples typically engage in sexual activity, he or she is physically exhausted and cannot participate. Just as the body often does not cooperate when a person is walking across the kitchen or navigating through the living room, it can balk during the physical activity of lovemaking. Partners may find that the “right time” is any time that happens to be right for both of them, which is not necessarily related to the clock or to previous habits. patience, humor, and innovation are key to a continuing, mutually satisfying sexual relationship between partners.