Sexuelle Dysfunktion und Hyper-sexualität bei Morbus Parkinson

Zusammenfassung

Das idiopathische Parkinson-Syndrom (IPS) geht mit einer Reihe nicht motorischer Phänomene einher. Dabei spielen Störungen der Sexualfunktion und des Sexualverhaltens eine wichtige Rolle, da sie oft mit einer Verschlechterung der Lebensqualität und Zufriedenheit in der Partnerschaft verbunden sein können. Bei männlichen Parkinson-Patienten stehen erektile Dysfunktion, Ejakulationsstörungen und vermindertes sexuelles Verlangen im Vordergrund, wohingegen Frauen von verminderter Libido, unzureichender vaginaler Sekretion und Dyspareunie berichten. Anpassung der medikamentösen Therapie kann beim Beischlaf störende motorische Phänomene des IPS erfolgreich behandeln. PDE-5-Inhibitoren sind zur Behandlung der erektilen Dysfunktion auch bei IPS wirksam. Bei bis zu 10% der Patienten führt die medikamentöse Parkinsontherapie zu Hypersexualität, was für den Patient und dessen Umfeld eine erhebliche Belastung darstellt und strafrechtliche Konsequenzen haben kann. Behandler sollten sowohl sexuelle Dysfunktion als auch Hyper-sexualität offensiv erfragen und das Bewusstsein für das Auftreten dieser Symptome schärfen, um frühzeitig intervenieren zu können.

Summary

Parkinson’s disease (PD) is associated with numerous non-motor phenomena, among which sexual dysfunction and abnormal sexual behavior play a major role, as they are often associated with deterioration in quality of life and satisfaction in their partnership for the patient as well as their partner. Male PD patients suffer from erectile dysfunction, premature or delayed ejaculation and loss of libido, whereas female patients complain of decreased libido, insufficient vaginal lubrication and dyspareunia. Adjustment of medication ameliorates inhibiting motor symptoms. PDE-5-inhibitors are effective in treating erectile dysfunction in PD. Up to 10% of PD patients suffer from hypersexuality under medical treatment for PD, which is a disabling feature for both the patient and partner, and can even become a matter of criminal law. Treating physicians, above all neurologists, have to raise awareness of these symptoms and side effects of treatment, and pro-actively inquire sexual abnormalities in PD patients to enable early intervention.

Schlüsselwörter

Parkinson - sexuelle Dysfunktion - Hypersexualität

Keywords

Parkinson’s disease - sexual dysfunction - hypersexuality

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