The PRIAMO study: active sexual life is associated with better motor and non‐motor outcomes in men with early Parkinson's disease

So with your good chance of getting Parkinsons post stroke, ask your doctor EXACTLY how much sex you need to prevent Parkinsons. And what should women do? 

What to do for those who are not coupled up? Does masturbation work?

Or  Electrosex? Inquiring minds want to know.

Parkinson’s Disease May Have Link to Stroke March 2017

The PRIAMO study: active sexual life is associated with better motor and non‐motor outcomes in men with early Parkinson's disease

M. Picillo

R. Palladino

R. Erro

C. Colosimo

R. Marconi

A. Antonini

P. Barone

on behalf of

the PRIAMO study group

First published: 02 July 2019

https://doi.org/10.1111/ene.13983

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Abstract

Background and purpose

Data suggest a relationship between sexual dysfunction, mainly erectile dysfunction in men, and worse disease progression in Parkinson's disease (PD). There is scant evidence on the correlates of sexual activity in PD patients. By involving a subgroup of 355 patients from the PRIAMO (Parkinson Disease Non Motor Symptoms) study, the present 24‐month longitudinal prospective analysis aims to demonstrate that the presence of active sexual life is associated with disease progression in early PD.

Methods and results

Multivariable mixed‐effect logistic regression models showed that gastrointestinal symptoms [odds ratio 0.56, 95% confidence interval (CI) 0.39–0.82, P = 0.003] and apathy (odds ratio 0.42, 95% CI 0.29–0.63, P < 0.001) were less likely to be associated with sexual activity in men. Analysis also demonstrated that sexual activity in men was associated with lower motor disability (coefficient −2.881, 95% CI −4.732 to −1.030, P = 0.002), better quality of life (coefficient −24.196, 95% CI −44.884 to −3.508, P = 0.022; coefficient 0.083, 95% CI 0.023–0.143, P = 0.006) and lower depression scores (coefficient −1.245, 95% CI −2.104 to −0.387, P = 0.004). No association was shown in women.

Conclusions

This is the first prospective longitudinal study involving a large cohort of PD patients suggesting that sexual activity is associated with lower motor and non‐motor disability as well as with better quality of life in men. These findings should prompt movement disorders specialists to periodically inquiry about their patients’ sexual life.

Introduction

Sexual activity is a complex process requiring a coordinated functioning of the person's mental, autonomic, sensory and motor systems and relies on proper function of the neurological, vascular and endocrine system as well as a healthy emotional state 1. Indeed chronic diseases have an impact on sexual function through both direct and indirect mechanisms 1.
As patients with Parkinson's disease (PD) have to cope with important changes in their sexual function, achieving a satisfying intimate and sexual relationship is often a challenge 2. On the other hand, evidence shows that quality of sexual expression improves general satisfaction of life in PD patients 3.
Psychosocial (religion, cultural background and role changes) and individual factors have a diverse impact on sexuality and sexual functioning determining the high gender specificity of the topic 1, 4.
From the clinician's perspective, examination of a patient's sexual life is often neglected during the clinical interview. Likewise, the most commonly used tools to evaluate non‐motor symptoms (NMS) as well as health‐related quality of life (HR‐QoL) in PD contain either a few or no items related to sexual function. Yet, as effective pharmacological and behavioural therapies for sexual problems are available, sex life should be proactively investigated 5.
Data available so far show a relationship between sexual dysfunction, mainly erectile dysfunction in men, and worse disease progression in PD 6, although an active sexual life rather than sexual function is considered a surrogate of general health 1. Notwithstanding, there is scant evidence on the correlates of sexual activity in PD patients.
By further analysing prospective data from a subset of patients of the PRIAMO (Parkinson Disease Non Motor Symptoms) study 7, 8, the present work aims to demonstrate that the presence of an active sexual life is associated with disease progression in early PD. In detail, the goals were to evaluate (1) whether an active sexual life is associated with better motor and non‐motor outcomes as well as quality of life and (2) the prevalence of sexual dysfunction in a cohort of sexually active PD patients.