title: Postural instability, the absence of sexual intercourse in the past month, and loss of libido are predictors of sexual dysfunction in Parkinson's disease.
abstract: OBJECTIVE
  To determine the prevalence and predictors of sexual dysfunction (SD) in Parkinson's disease (PD) patients.
  
  
  BACKGROUND
  Assessments of SD in the professional literature is limited. Understanding the predictors of SD can help physicians focus on this problem in vulnerable patients.
  
  
  METHODS
  A total of 60 PD patients and 60 controls answered the Arizona Sexual Experiences Scale-Thai Version (ASEX-Thai) and the Hamilton Depression Rating Scale (HAMD) questionnaires, and were asked on 3 additional sets of questions about premature ejaculation (PE), dyspareunia, and hypersexual disorders.
  
  
  RESULTS
  The prevalence of SD in PD patients and controls was 81.6% and 48.3% respectively (p < 0.05). PD patients had lower BMI, lower uric acid level, higher HAMD score and had sexual intercourse (SI) less frequently. SD correlated with greater disease severity and depression. The most distressing problem in male patients was PE (51.4%) and orgasmic dissatisfaction (76%) for female patients. Logistic regression analysis found 3 factors were related to SD: no SI in the past month (p < 0.001), postural instability (PI) (p = 0.028), and HAMD item 14 (p = 0.021), predicting SD with the OR of 12.2, 5.5, and 5.0 respectively.
  
  
  CONCLUSIONS
  SD in PD is common and usually occurs with depression. Absence of SI in the past month, PI, and loss of libido are predictors of SD in PD. A simple and quick screening of SD can be routinely performed by inquiring patients about the frequency of SI and the examination of the pull test. Detailed assessment of sexual functioning and depression may guide physicians in proper management.
authors.affiliation: Chulalongkorn Center of Excellence on Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand.
authors.forename: Onanong
authors.initials: O
authors.lastname: Jitkritsadakul
authors.affiliation: Chulalongkorn Center of Excellence on Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand.
authors.forename: Priya
authors.initials: P
authors.lastname: Jagota
authors.affiliation: Chulalongkorn Center of Excellence on Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand; Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles 90095, USA. Electronic address: rbh1@ucla.edu.
authors.forename: Roongroj
authors.initials: R
authors.lastname: Bhidayasiri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003075:Coitus; D005260:Female; D006801:Humans; D007989:Libido; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D004856:Postural Balance / Q000502:physiology; D011237:Predictive Value of Tests; D061686:Premature Ejaculation / Q000209:etiology; D012678:Sensation Disorders / Q000209:etiology*; D012720:Severity of Illness Index; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis* / Q000209:etiology*; D055815:Young Adult
keywords: Libido; Parkinson's disease; Postural instability; Sexual dysfunction; Sexual intercourse