Objective: To propose guidelines for neurologists to discuss sexual issues and offer education and practical solutions.

Background: Sexual dysfunction (SD) is a common nonmotor symptom in Parkinson’s disease (PD) but despite its negative impact on quality of life it is usually ignored in the patient-physician encounter.  Many sexual problems may be attended by the neurologist as they are associated with disease-related issues such as motor problems or medication side effects. Thus, it is necessary that neurologists be equipped with user-friendly diagnostic tools and a treatment algorithm.

Method: Based on considerable clinical experience (over 20 years) obtained from two large multidisciplinary movement disorders centers, we propose practical guidelines to assist physicians in managing SD in PD.

Results: A flowchart algorithm will be proposed to the neurologist suggesting 3 stages: 1. Initial screening and interview for SD in PD with patient and spouse. 2. Classification of SD according to weather it relates to motor symptoms (e.g. tremor, hypokinesia, bradykinesia, dyskinesia, drooling etc.), non-motor symptoms (neuropsychiatric -depression, apathy, attention deficit, loss of libido, dementia and genitourinary- urinary incontinence and erectile dysfunction or pain etc.), effect of medications (e.g. delayed orgasm due to antidepressant, impulse control disorders etc.), and partners’ relationships and burden (e.g. burn-out, rejection, SD of spouse etc.). 3. Interventional options according to a structured algorithm

Conclusion: The proposed guidelines will hopefully promote doctor-patient communication regarding SD in PD and enable addressing and improving an important aspect of human QoL and relationship.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-flowchart-algorithm-for-the-neurologist-to-discuss-and-attend-sexual-issues-in-parkinsons-disease/