The role of physiotherapy in improving sexual health in people with Parkinson's Disease

To investigate the impact of motor, non-motor, and social aspects on sexual health in men and women with PD.

Following the recommendations STROBE, we conducted a cross-sectional study of 100 women (mean age 54.45±8.31) and 80 men (mean age 53.55±10.8) with confirmed diagnoses of idiopathic PD in stages 1-3 of the Hoehn and Yahr classification, who reported an active sex life in the last six months. We collected data through remote interviews covering demographic and clinical features, global cognitive capacity, non-motor aspects of daily living experiences, motor aspects of daily living experiences, fatigue, self-esteem, sleep disorder, couple relationship quality (CRQ), and depressive signals. To assess sexual health, we used the Female Sexual Function Index (FSFI) for women and International Index of Erectile Function (IIFE) for men. Two multiple regression models were developed, one for women and another for men, including all factors with a statistically significant moderate correlation (R > 0.30) with the total FSFI and IIFE scores.

Results showed that although the sexual health of men and women with PD correlated with several motor, non-motor, and social factors, different factors predicted sexual health for women and men. For women, the relationship and sleep quality (adjusted R² = 0.36, F(_3.80) = 16.57 and p0.000001 were significant predictors of their sexual health, while for men, motor disability alone could predict their sexual health (adjusted R² = 0.355, F(_1.78) = 44.67 and p=0.00001). No significant correlations were found between sexual health and age, disease onset, or daily medication dosage for both women and men with PD.

In conclusion, the level of motor disability predicts the sexual health of men with PD, but not of women, regardless of age and disease severity.

Decreased sexual health is associated with decreased quality of life in people with PD. Physiotherapists should consider evaluating motor disability related to sexual health in men with PD, such as mobility in bed, and include their improvement in therapeutic aims. Physiotherapists should also consider evaluating sexual health in women with PD to make effective referrals to other health professionals.