Unfortunately, PD patients more frequently report general dissatisfaction with their sexual experiences compared to aged-matched controls. On one self-administered questionnaire, almost 81 percent of PD men and 43 percent of PD women reported diminished sexual activity, associated with severity of disease, motor symptoms, depression, autonomic dysfunction, and medications. ED affects between 10 and 30 million men in the United States, but its prevalence is even higher in men with PD, with estimates ranging from 30 to 60 percent. Vascular insufficiency is the most common cause of ED in the general population, but autonomic dysfunction, fatigue, motor symptoms, and medications may contribute to the higher incidence of ED in PD patients.
Research regarding sexuality in PD women is sparse.
Welsh et al studied sexual function in women with PD, and found a high level of dissatisfaction with the quality of their sexual experiences and with body image. Medical problems, including vaginal tightness and urinary difficulties, also interfered with sexual enjoyment. Although nearly 50 percent of women with PD were sexually active, the overall level of satisfaction with sexual relationships was diminished compared to aged-matched controls. Sildenafil citrate was the first oral agent approved by the U.S. Food and Drug Administration to treat ED, and works by selectively inhibiting the breakdown of cGMP in the corpus cavernosum. It has been found to improve ED in 46 to 73 percent of men in the general population.