IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy.
Department of PD, Movement Disorder and brain Injury rehab, Moriggia Pelascini Hospital, Gravedona, Italy.
J Sex Med. 2020 Oct;17(10):1914-1925. doi: 10.1016/j.jsxm.2020.06.010. Epub 2020 Jul 11.
Prevalence rates of sexual dysfunction (SD) in Parkinson's disease (PD) are likely to be underestimated and their etiology is still unknown. More understanding of this issue is needed.
To investigate prevalence of SD and its variables, including gender differences, in a sample of PD patients.
This multicenter observational study included 203 patients (113 males and 90 females) affected by PD (diagnosed according to UK Parkinson's Disease Society Brain Bank clinical diagnostic criteria 28), and living in 3 different Italian regions. Patients were evaluated using a semi-structured interview (a 40-item ad hoc questionnaire, developed by the authors to investigate patient's 3 main life areas: sociodemographic information, illness perception, and sexuality) and specific standardized scales to investigate SD, as well as by means of tools to assess their motor impairment, daily life activities, and disease-related caregiver burden (CBI).
The International Index of Erectile Function and the Female Sexual Function Index.
Sexual dysfunction was observed in about 68% of men, and in around 53% of women loss of libido being the main sexual concern in both sexes. Men were significantly more affected by SD than women (χ (1) = 4.34, P-value = .037), but no difference in the severity of the dysfunction emerged between genders. Around 85% of PD patients had a stable couple relationship, and about 40% were satisfied with such a relationship. However, about 57% of the patients stated that the disease affected their sexual life, especially due to reduced sexual desire, and the frequency of sexual intercourses. Moreover, significant differences between subjects with SD and subjects without SD were found in UPDRS (I-II-III domains), in Hamilton Depression Rating Scale and CBI scores.
Clinicians dealing with PD should pay more attention to sexual issues, as discussing and treating sexual problems enters the framework of a holistic approach, which is mandatory in chronic illness.
STRENGTHS & LIMITATIONS: The major strengths of this study include the multicenter nature of the study, to overcome single-center methodological bias. The main limitation is the relatively small sample size, and the absence of a control group, even if there are growing literature data on sexuality and aging supporting our findings.
SD is a highly prevalent and devastating problem in patients affected by PD, negatively affecting their quality of life. Raciti L, De Cola MC, Ortelli P, et al. Sexual Dysfunction in Parkinson Disease: A Multicenter Italian Cross-sectional Study on a Still Overlooked Problem. J Sex Med 2020;17:1914-1925.
帕金森病（PD）患者性功能障碍（SD）的患病率可能被低估，其病因仍不清楚。需要更多地了解这一问题。
调查 PD 患者 SD 及其变量的患病率，包括性别差异。
本多中心观察性研究纳入了 203 名 PD 患者（男性 113 名，女性 90 名）（根据英国帕金森病学会脑库临床诊断标准 28 诊断），居住在意大利的 3 个不同地区。使用半结构式访谈（作者开发的 40 项特定专题问卷，用于调查患者的 3 个主要生活领域：社会人口信息、疾病认知和性行为）和特定的标准化量表来调查 SD，并使用工具来评估他们的运动障碍、日常生活活动和与疾病相关的照顾者负担（CBI）。
国际勃起功能指数和女性性功能指数。
约 68%的男性和约 53%的女性出现性功能障碍，性欲减退是两性主要的性关注问题。男性的 SD 明显比女性更严重（χ (1) = 4.34，P 值= 0.037），但两性之间性功能障碍的严重程度无差异。约 85%的 PD 患者有稳定的伴侣关系，约 40%对这种关系感到满意。然而，约 57%的患者表示疾病影响了他们的性生活，尤其是性欲降低和性生活频率降低。此外，在 UPDRS（I-II-III 领域）、汉密尔顿抑郁量表和 CBI 评分方面，SD 患者和非 SD 患者之间存在显著差异。
治疗 PD 的临床医生应更加关注性功能问题，因为讨论和治疗性功能问题是整体治疗方法的一部分，这在慢性病中是强制性的。
本研究的主要优势在于研究的多中心性质，以克服单中心方法学偏见。主要的局限性是样本量相对较小，并且缺乏对照组，尽管关于性行为和衰老的文献数据不断增加，支持我们的研究结果。
SD 是 PD 患者中一种高发且严重的问题，对患者的生活质量产生负面影响。Raciti L, De Cola MC, Ortelli P, et al. Sexual Dysfunction in Parkinson Disease: A Multicenter Italian Cross-sectional Study on a Still Overlooked Problem. J Sex Med 2020;17:1914-1925.
