Sexual function in men and women with neurological disorders.
The advent of non-invasive functional brain imaging has clarified which regions of the brain are recruited during sexual arousal. Injuries to those regions, and to the spinal cord and peripheral nerves that link genitalia to limbic and cognitive centres, can profoundly influence sexual wellbeing. In epilepsy, expressions of hypersexuality and hyposexuality interact with the location of epileptogenic foci in the temporolimbic circuitry, and are tempered by the sexual effects of drug treatments. We outline the sexual consequences of epilepsy, stroke, multiple sclerosis, Parkinson's disease, and other common neurological disorders. Management of sexual dysfunction from both disease and treatment is discussed. Nerve-sparing techniques could mitigate the substantial sexual dysfunction in both men and women through surgical disruption of the autonomic nerves during radical pelvic surgery.
Rees
Peter M
PM
Burnaby Hospital, Neurology Department, Burnaby, BC, Canada. bassonrees@telus.net
Fowler
Clare J
CJ
Maas
Cornelis P
CP
D017776:Autonomic Pathways / Q000293:injuries; D001921:Brain / Q000502:physiology; D001930:Brain Injuries / Q000150:complications; D004827:Epilepsy / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D009069:Movement Disorders / Q000150:complications; D009103:Multiple Sclerosis / Q000150:complications; D009422:Nervous System Diseases / Q000150:complications*; D010388:Pelvis / Q000294:innervation; D010523:Peripheral Nervous System Diseases / Q000150:complications; D011128:Polyradiculopathy / Q000150:complications; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology*; D019529:Sexuality / Q000502:physiology / Q000523:psychology; D013119:Spinal Cord Injuries / Q000150:complications; D020521:Stroke / Q000150:complications