Role of Sexual Health Professional
Contributed by Gila Bronner, MPH, MSW (Sex Therapist) and Woet Gianotten, MD (Psychotherapist; consultant in rehabilitation sexology)
"Sex therapy" is a type of therapy effective for adults of any age, gender or sexual orientation. Through sex therapy, one can address sexual problems and concerns about sexual function, sexual feelings and intimate relationships - either in individual or in couple sessions. Sex therapy is usually provided by psychologists, social workers, physicians or other licensed therapists, who have been formally trained and mentored. A subgroup of these professionals focuses on disease-related sexual problems and is experienced in the areas of medical sexology/sexual medicine. While this therapy can be specifically tailored to the needs of Parkinson patients, this approach is equally helpful for people with other movement disorders.
People with Parkinson’s Disease (PwPD), as well as their partners, experience significant sexual changes in the course of the disease. Common problems are:
● a desire disorder (‘too low’, ‘too high’ or too much difference between the partners);
● erectile difficulties, premature ejaculation or trouble in reaching orgasm;
● pain during sexual activity; and sexual dissatisfaction.
These changes can be part of the natural progression of the disease or the sexual side effects of PD medication or both.
Natural age-related sexual changes in men and women, as well as myths about sexuality, may add even more distress to one’s sexual life. In the vast majority of couples with PD, the disease itself or treatments can negatively influence sexual function, sexual identity and sexual relationships, resulting in diminished intimacy and quality of life. The overall goal of sex therapy is re-establishing pleasure and satisfaction, rather than achieving perfect genital response.
The movement disorders sexual health professional is able to assist PwPD and their partners by:
Providing information on sexual function and dysfunction;
Providing information on how Parkinson disease effects individual and couple sexuality;
Dispelling common myths and describing how individual sexual preferences differ;
Discussing ethnic, cultural and religious influences;
Treating in several ways: learning to give and receive enjoyable touches, reducing stress and improving relaxation, relationship therapy, cognitive restructuring, improving communication skills, pro-sexual medications and ‘tools and toys.’
Counseling: One of the sexual health benchmarks is the belief that every person is entitled to realize one’s sexual potential, both emotionally and physically and to share intimate thoughts, feelings and activities with a partner. In our experience, PwPDs are regularly deprived of this right because of their own barriers about how to ask for counseling or due to health care professional barriers: discomfort in introducing, openly discussing and referring PwPD to qualified therapists.
Sexual health professionals usually work in an interdisciplinary team where they also provide a range of services to health care professionals, such as:
● Training in sexual communications in the medical setting;
● Help in accessing sexual health provider networks;
● Providing brief consultations in the clinical setting;
● And, management strategies
Incrocci L, Gianotten WL. Disease and Sexuality. In: Rowland DL, Incrocci L. (eds) Handbook of Sexual and Gender Identity Disorders. Hoboken, John Wiley & Sons, 2008: 284-324.
Bronner G, Royter V, Korczyn AD, Giladi N.Sexual dysfunction in Parkinson’s disease. J Sex Marital Ther. 2004;30(2):95-105.