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Parkinson's disease - Management
How do I manage sexual dysfunction in people with Parkinson's disease?
- If hypersexuality is reported:
- Suspect that it may be caused by dopaminergic therapy (even when there is erectile dysfunction) and contact the person's Parkinson's disease specialist team.
- If erectile dysfunction or anorgasmia is reported:
- Exclude comorbid endocrine abnormalities (such as hypothyroidism or hyperprolactinaemia).
- Consider the possibility of underlying depression.
- Consider discontinuing drugs associated with erectile dysfunction (such as alpha-blockers) or anorgasmia (such as selective serotonin reuptake inhibitors [SSRIs]).
- Consider prescribing a phosphodiesterase type-5 inhibitor for erectile dysfunction (sildenafil, tadalafil, or vardenafil), which are available on the NHS for men with Parkinson's disease. The prescription must be endorsed 'SLS' by the prescriber.
- Avoid these drugs in people with hypotension (systolic blood pressure less than 90 mmHg), and use with caution in people with postural (orthostatic) hypotension.
- For more information, see the CKS topic on Erectile dysfunction.
- Consider referral to a urological specialist or specialist services for erectile dysfunction.
In depth
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