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Does Viagra Help Parkinson’s

History And Physical Examination

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Medical and surgical history, sexual history, use of medications and other substances, and an assessment of psychological and relationship health are key components of the patient history. Essential parts of the physical examination include measurement of blood pressure, body mass index, and waist circumference to assess abdominal obesity; a genital examination; and an assessment of male secondary sex characteristics.

Causes Of Erectile Dysfunction

To understand why ED happens, it helps to know how an erection occurs. An erection actually starts in your head. When you become aroused, signals in your brain travel to other parts of your body. Your heart rate and blood flow increase. Chemicals are triggered that make blood flow into hollow chambers in your penis. This causes an erection.

In ED, however, an enzyme called protein phosphodiesterase type 5 interferes with this process. As a result, theres not an increase in blood flow to the arteries in your penis. This stops you from getting an erection.

ED can be caused by a number of factors. These can include health issues such as:

  • increasing age
  • medications, such as diuretics, blood pressure drugs, and antidepressants
  • multiple sclerosis

Strategies To Improve Your Sexual Health

These challenges can naturally make anyone with PD concerned. Your first step should be speaking openly and honestly with your doctor about what you are experiencing. Remember that these issues are not uncommon in people with Parkinson’s and your doctor is there to help.

In particular, see your doctor to:

  • Identify the root cause of the problem. If it is related to depression, treat the depression; if it is related to a reduction in sex hormones, ask your doctor about hormone replacement therapy, and so forth.
  • Review your medications. Sometimes the root problem is the dose of PD medication you are on. Consult with your PD doctor about adjusting the dose.

You can also take steps that may be helpful on your own:

  • Engage in vigorous exercise whenever you can as it will improve physical stamina, libido, and mobility.
  • Seek out physical therapy to improve mobility.
  • Try cognitive-behavioral therapy and psychotherapy, which may help you talk through worries, fears, and feelings of loss. Getting beyond these negative feelings may allow you to more fully enjoy the moment with your partner.
  • Consider taking a massage class with your partner to find new ways to maintain intimacy while you are struggling with sexual dysfunction.
  • Talk with your partner about what you are going through. Understanding starts with open dialogue.

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Psychological Issue: Depression And Sex

With diagnosis and decreased physical capacity, a persons sense of self is disrupted with Parkinsons. Parkinsons itself can cause changes in the brains chemicals that impact ones mood and well-being. Depression can affect up to 40 percent of those with Parkinsons. This is important to realize since sexual disorders may be due to the depression that can come with Parkinsons diagnosis more than by the actual disease itself. The antidepressant medications that may be administered can also result in sexual dysfunction.

Other emotional issues for those who have Parkinsons, which may result in sexual difficulties, include: anger, stress, grief, and mental fatigue. An individual grappling with Parkinsons may experience reduced self-esteem, which can inhibit ones sexuality. Such is made even more difficult by the body image problems that can arise, due to issues like changes in skin texture or the body smell that results from consuming Parkinsons drugs.

The partner of a person with Parkinsons can also have trouble coping with the situation. Issues that may arise include:

  • Fatigue and resentment in taking on more responsibility.
  • Dealing with their own feelings related to a partners diagnosis, like fear, anxiety, and depression.
  • Loss of attraction and sexual interest due to the symptoms of PD, e.g., involuntary movements or changes in appearance, like the lack of facial expression.

Sexual Problems In Parkinsons

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As with any subject that makes us the least bit embarrassed, sexual problems often are swept under the rug. The subject is seldom mentioned outside the bedroom and may rarely be brought up to your doctor. Still, sexual changes are a common part of getting older and;occur frequently among people with Parkinsons.

You can continue to have healthy sexual relationships while living with Parkinson’s disease , but you may experience new challenges. The symptoms of Parkinson’s can create barriers to intimacy, and many people with Parkinson’s experience emotions that affect their sexual relationships, such as anxiety, fear and insecurity about physical changes. The stress of caring for a loved one with PD can make you feel tired, anxious or even resentful.;Talking with your partner is key to finding solutions;that work for both of you. If you can remain open, honest and patient and remember that physical closeness takes many forms you and your partner can, together, discover many ways to adapt.

Your doctor is a source of help.;Treatments and strategies are available, but people often don’t talk to their doctors about sexual matters. Sharing this aspect of your life with PD with your physician can help you maintain a healthy sexual relationship and quality of life.

Parkinson’s symptoms and medications can bring changes in sexual health:

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  • A person who has Parkinsons disease faces many challenges, including the possibility of reduced sexual feeling and function.
  • Parkinsons can affect the partners sexuality too.
  • Communication is the best remedy for all types of relationship problems, including sexual problems.
  • Always see your doctor if you are concerned about your medical condition, treatment, sexuality or sexual relationship.

How Can I Lower My Cholesterol

Here are a few tips for lowering cholesterol:

  • Eat fewer fats and fried foods. Choose non-fat and low-fat versions of foods, if available.
  • When eating fats, select unsaturated fats.
  • Choose fish and poultry more often than red meat.
  • Limit total amount of meat, fish, poultry, and low-fat cheeses to 7 ounces or fewer each day.
  • Exercise.
  • Eat more soluble fiber. Good sources are fruits, beans, peas, and oats.
  • Limit egg yolks to no more than three per week.

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Assessing Your Cardiovascular Health

Your GP may assess your cardiovascular health. Narrowed blood vessels are a common cause of erectile dysfunction and linked with cardiovascular disease .

Your GP may:

As well as helping to improve your;erectile dysfunction, these changes can also improve your general health and may help to reduce your risk of cardiovascular disease .

Read more about;preventing cardiovascular disease;;

How Much Cholesterol Is Too Much

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A healthy cholesterol level depends on a variety of factors, including:

  • your level of HDL cholesterol compared with your level of LDL cholesterol
  • your total cholesterol
  • your number of risk factors for heart disease
  • your age and activity level
  • your current health status

Excess LDL cholesterol in your blood gets deposited in arteries, the blood vessels that feed the heart and brain. These deposits can join with other substances to form plaque, a thick, hard deposit in the blood vessel that leads to atherosclerosis. Plaque can narrow the passageway inside the artery and pinch off the flow of blood to the heart muscle, and to the penis.

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Treatment For Parkinsons Disease Can Affect Sexuality

Parkinsons is incurable, but most of the symptoms are manageable with medication or surgery. However, medication can diminish sexual desire and reduce sexual response. Medication which improves motor or physical functions is mainly taken during the waking hours, lower levels at night may also affect sexual function. Some medications may cause an increase in desire , which is a rare side effect. Talk to your doctor about treatment side effects.

Communicating About Sexual Dysfunction

Based on the pathway and the mechanism of Parkinsons, many of us will likely experience some sexual dysfunction at some point. For me, its a matter of connection and communication with my partner, knowing that she realizes whats going on physically and emotionally with my disorder.

It is essential for me to communicate with my physicians about whats going on. The reality is that erectile dysfunction can be treated with relative ease using the generic form of Viagra .

Its also crucial to maintain the physical connection with your partner, keep trying to find common points that intertwine intimacy with sex. One suggestion, and its a difficult concept, is to not invite Parkinsons into your most private and intimate settings. In the backdrop of living with Parkinsons, try hard to keep this close relationship with your partner supportive, durable, and steady.

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Male Sexual Disorders In Patients With Parkinson Disease: Treatment With Natural Remedies

Kameni Poumeni Mireille,

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Department of Animal Biology and Physiology, University of Yaounde I, Cameroon

Correspondence: Kameni Poumeni Mireille, University of Yaounde I, PO BOX 812, Yaounde, Cameroon, Tel 237 699 288 365

Citation: Mireille KP, Desire DDP, Pierre K. Male sexual disorders in patients with parkinson disease: treatment with natural remedies. Adv Tissue Eng Regen Med Open Access. 2017;3:355360. DOI: 10.15406/atroa.2017.03.00061

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Introduction

Erectile dysfunction is a problem with getting and maintaining an erection thats firm enough to have sexual intercourse. All men have trouble getting an erection from time to time, and the likelihood of this problem increases with age. If it happens to you often, though, you may have ED.

Viagra is a prescription drug that can help men with erectile dysfunction. For many people, romance means candlelight, soft music, and a glass of wine. The little blue pill, Viagra, can be part of this picture, but only if you drink small or moderate amounts of alcohol.

Clinical Pharmacology and Therapeutics found no adverse reactions between Viagra and red wine. However, research on this topic is limited.

Still, just because Viagra and alcohol dont seem to interact doesnt mean that its a good idea to use them together. This is because chronic alcohol use is a common cause of ED. Its so common, in fact, that a slang term for ED in Great Britain is brewers droop. So while youre treating ED with Viagra, you may be doing yourself a disservice by mixing the drug with alcohol.

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Physical Issues Of Your Sex Drive

Parkinsons affects ones autonomic nervous system, which controls sexual response and functioning. Parkinsons acts upon neurons in the brains substantia nigra, causing dopamine-producing nerve cells to die. Since dopamine is a chemical that transmits signals between parts of the brain that usually coordinate smooth muscle movement, this is critical to sexual function on two fronts.

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First, this dopamine drop may result in a decreased sex drive and sexual interest. Second, the lower levels of dopamine that result are believed to cause ones loss of balance, changes in walking pattern and posture, muscle rigidity, Bradykinesia , and tremors when resting. The symptoms of Parkinsons can also be seen in:

Hypothalamic Neurons And Dopamine

In experimental animals, dopamine is known to facilitate erection and mating behaviors. The MPOA/PVN receives projections from the nigral dopaminergic neurons . A microdialysis study showed that the dopamine concentration in the MPOA was increased by sexual stimulation. It is reported that dopamine D1/ D2 receptors in the hypothalamus participate in erection, whereas only D2 receptors participate in ejaculation. Pathology studies have shown that the hypothalamus is affected in PD . Recently, a polymorphism in the dopamine D4 receptor gene has been shown to contribute to individual differences in human sexual behavior . Prolactinergic neurons are thought to be inhibitory to sexual function. Serum prolactin levels increase after orgasm in healthy men. Prolactin-producing pituitary tumors often cause gynecomastia and erectile dysfunction in male patients. Hyperprolactinemia occurs after the use of sulpiride, metoclopramide, and chlorpromazine . Therefore, dopaminergic neurons seem to facilitate oxytocinergic neurons, whereas they inhibit prolactinergic neurons. Some de novo PD patients have hyperprolactinemia , which may contribute to erectile dysfunction in those patients.

Fig.;1.

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Parkinson’s And Female Sex Drive

Common sexual issues in women with Parkinson’s disease include loss of lubrication and involuntary urination during sex. Sex can be uncomfortable because of a lack of lubrication and desire.

For women with PD who have experienced menopause, the decline in sexual interest may be due to both menopause and PD. Hormone replacement therapy may help the physical effects of menopause.

An added benefit is that such therapy can help keep bones strong and flexible. Never, however, take any hormonal supplements without consulting with your doctor first.

Why Does Erectile Dysfunction Happen

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Erectile dysfunction;can have a range of causes, both physical and psychological. Physical causes include:

Psychological causes of ED include:

Sometimes erectile dysfunction only occurs in certain situations. For example, you may be able to get an erection during masturbation, or you may find that you sometimes wake up with an erection but you are unable to get an erection with your sexual partner.

If this is the case, it is likely the underlying cause of erectile dysfunction is psychological . If you are unable to get an erection under any circumstances, it is likely that the underlying cause is physical.

Erectile dysfunction can also be a side-effect of using certain medicines.

Read more about the causes of erectile dysfunction

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Medications And Substance Use

Many medications cause or exacerbate ED .912 Antidepressants are a common cause, especially the selective serotonin reuptake inhibitors citalopram , fluoxetine , paroxetine , and sertraline , and the serotonin-norepinephrine reuptake inhibitor venlafaxine. Bupropion , mirtazapine , and fluvoxamine are less likely to cause ED.11 Tobacco, alcohol, and illicit drugs can cause ED.13,14 Marijuana use may cause ED, although further study is needed.15

Medications and Substances That May Cause or Contribute to Erectile Dysfunction

Alcohol, nicotine, and illicit drugs

Analgesics

Anticonvulsants

Antidepressants

Antihistamines

Antihypertensives

Antiparkinson agents

Antipsychotics

Cardiovascular agents

Cytotoxic agents

Diuretics

Hormones and hormone-active agents

Immunomodulators

Information from references 9 through 12.

Medications and Substances That May Cause or Contribute to Erectile Dysfunction

Alcohol, nicotine, and illicit drugs

Analgesics

Anticonvulsants

Antidepressants

Antihistamines

Antihypertensives

Antiparkinson agents

Antipsychotics

Cardiovascular agents

Cytotoxic agents

Diuretics

Hormones and hormone-active agents

Immunomodulators

Information from references 9 through 12.

Treatment Modalities For Sexual Dysfunction In Parkinsons Disease

Given the high prevalence of SD in patients with PD, physicians and other healthcare providers should discuss and treat sexual health issues as an integral part of treating the disease. In all instances, drug regimens should be reviewed for possible effects on sexual function. Sexual education, counselling and specific suggestions about therapeutic methods are important, and should be provided by the treating physician.

In a newly diagnosed patient with PD the possible enhancing influence of dopaminergic treatment on sexuality should be discussed with both partners. The improved libido in the male PD patient may be unwelcome, as the elderly spouse has already settled in a situation of not being bothered. The emergence of hypersexuality in the treated PD patient is, as a rule, drug induced, and modification of treatment is helpful. Profound loss of libido in the well-treated PD patient may call for an endocrinological consultation if it causes distress.

In a newly diagnosed PD patient who present with SD, the dopaminergic drugs should be introduced first, and their effect followed up. Occasionally, the SD will also improve. Difficulties with the motor aspects of the sexual activity may be overcome by counselling and appropriate timing of dopaminergic treatment. Poor lubrication in the female patient with PD may be helped by lubricants; urge incontinence during coitus by previously emptying the bladder and treating the overactive bladder.

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Parkinson’s And Male Sex Drive

Men with Parkinsons disease may experience difficulty obtaining/maintaining an erection or ejaculating during sexual intercourse.

Abnormalities in the function of the autonomic system may be one contributing cause of erectile dysfunction in men with PD. Erectile dysfunction in Parkinsons disease can also be directly related to the low dopamine levels of the brain.

Other common disorders related to aging, like diabetes, hypertension, and high cholesterol, can also contribute to erectile dysfunction.

Sildenafil can sometimes help with erectile dysfunction. Testosterone replacement therapy may also help with both erections and desire.

Parkinsons Disease Sexuality And Practical Suggestions

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Every couple affected by Parkinsons has a different experience. Generally speaking, you could try to:;

  • Learn about the effects Parkinsons and its treatment can have on sexuality.
  • Appreciate and recognise the emotional stress you are both going through, even if you are going through it differently. Make every effort to show love, respect, warmth and togetherness in non-sexual ways.
  • Talk frankly and openly about sexual needs. Communication is the best remedy for all types of relationship problems.
  • Experiment with different routines for example, switch lovemaking to the morning when Parkinsons symptoms tend to be less pronounced or when you have better mobility .
  • Place the emphasis on different physical expressions of lovemaking for example, foreplay, touching and kissing rather than penetration.
  • Explore and practice different, comfortable positions for successful and pleasurable penetration.
  • Adopt new sexual roles according to your and your partners abilities.
  • Find new solutions for physical stimulation .
  • Work together with medical staff to reduce the effects of medications on sexual function.

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