A comprehensive approach to sexual health in movement disorders includes assessing biological, psychological, and sociocultural factors, with interventions like sexual therapy, supportive psychotherapy, pharmacological treatments and medical devices, though further research is needed to establish evidence-based treatments in this population.
Key Findings
Background
Sexual health concerns are commonly overlooked in neurological clinics despite their importance to quality of life in patients with movement disorders.
A satisfying sexual life is described as 'essential for maintaining good quality of life and healthy relationships for all individuals, including those with movement disorders and their partners'
The authors note that its significance is 'often overlooked in neurological clinics'
The review draws from both published literature and the authors' own clinical experience
The paper addresses both patients with movement disorders and their partners
Results
Sexual problems in movement disorders span multiple categories including sexual dysfunction, sexual pain disorders, sexual compulsivity, and paraphilic behaviors.
The review identifies four major categories of sexual problems: sexual dysfunction, sexual pain disorders, sexual compulsivity, and paraphilic behaviors
Each category is connected to different specific movement disorders
The authors note connections between these sexual problems and both the underlying movement disorders themselves and their treatments
Neurologists are identified as able to play 'a key role in addressing sexual health concerns, considering the impact of both the disorder and its treatments'
Methods
Assessment of sexual health in movement disorders should encompass biological, psychological, and social factors, including investigations for structural, vascular, or hormonal causes.
The authors recommend a comprehensive assessment framework covering biological, psychological, and sociocultural factors
Investigations for structural, vascular, or hormonal causes are specifically recommended
Brief assessment questionnaires are discussed as part of the evaluation approach
The biopsychosocial model is reflected in the diagnostic and management framework presented
Background
Models of sexual response are presented as useful frameworks for diagnostic classification and management of sexual health issues in movement disorder patients.
The review introduces 'fundamental concepts of sexual medicine, emphasizing models of sexual response that offer useful frameworks for diagnostic classification and management practices'
These models are applied specifically to the movement disorders context
The framework is intended to be practical for use by neurologists in clinical settings
Results
Management of sexual health in movement disorders requires individualized approaches including sexual therapy, psychotherapy, pharmacological adjustments, and mechanical devices, with special considerations for deep brain stimulation patients.
Interventions discussed include specific sexual therapeutic practices, supportive psychotherapy, pharmacological treatment adjustments, and mechanical devices
Adjustments to pharmacological treatments related to movement disorders are specifically addressed as a management strategy
Deep brain stimulation surgery patients are highlighted as requiring individualized management
The authors acknowledge that 'further research is needed to establish evidence-based treatments in this population'
Results
Hypersexuality and sexual compulsivity are recognized as treatment-related complications in movement disorders, particularly linked to dopaminergic therapies.
Sexual compulsivity is listed as one of the major sexual problem categories addressed in the context of movement disorders
Paraphilic behaviors are also discussed in relation to movement disorder treatments
Pharmacological treatment adjustments are presented as a management strategy, implying medication-related sexual behaviors
The connection between movement disorder treatments and sexual problems is explicitly noted throughout the review
What This Means
This research suggests that sexual health problems are common but frequently ignored in people with movement disorders such as Parkinson's disease, and that neurologists should take a more active role in addressing them. The paper reviews the scientific literature and the authors' own clinical experience to provide a practical guide for how doctors can assess and treat sexual health concerns in this patient population. Problems range from sexual dysfunction and pain to compulsive sexual behaviors, which can be caused by the neurological condition itself, its treatments (such as dopamine-based medications), or psychological and social factors.
This research suggests that a thorough evaluation should look at biological factors (such as hormonal, vascular, or structural issues), psychological factors, and social or cultural influences on sexual health. The authors also highlight that patients receiving deep brain stimulation surgery may need especially tailored management. Treatment options discussed include sex therapy, supportive counseling, adjusting medications, and the use of medical devices.
This research suggests that while a practical framework now exists for clinicians to follow, there is currently a lack of high-quality clinical trial evidence specifically for treating sexual health problems in movement disorder patients. The authors call for more research to develop evidence-based treatments for this underserved group, and emphasize that both patients and their partners can benefit when neurologists take sexual health concerns seriously as part of overall care.
Chen J, Munhoz R, Lang A, Briken P, Ganos C. (2025). A Pragmatic Approach to Sexual Health in Movement Disorders.. Movement disorders clinical practice. https://doi.org/10.1002/mdc3.70198