To all readers,
Now an answer to the sex question is coming, oldfashioned or post-modern. I
have some knowledge of this matter from experience and from conversation
with co-PWP's. Some years ago I attended a meeting of the Dutch patient
organisation were sex was the topic to be discussed.
At the beginning of the treatment with dopamine quite wild stories were
going on about male patients who after their first pill couldn't leave the
nurses alone. If those reports are true this was possibly caused by the
very high doses given at that time. But a more modest aphrodisiac effect of
L-dopa was reported by man and woman alike.
I myself have this experience. Some people had been surprised by their own
reaction. They experienced a diminished desire before starting with meds. I
think it is important that all users of L_dopa know about the possibility
of this effect. Once I was told a marriage broke down while the husband
couldn't bear the increased demands of his PD wife.
PWP'S differ in this respect also. Not everyone gets this pos. effect. On
the contrary some told that all their sexual feelings had disappeared and
did not come back with L_dopa. This can be a cause of impotence.
Knowing some things about the relation between sex-drive and neurotrans-
mitters it is plausable PD itself diminishes sex-drive. It has something to
do with cholinergic vs. anti-cholinergic stimulation, two things that don't
go together. Sexual functioning needs anti-cholinergic activation and a PWP
without meds has to much cholinergic stimulation.
The disappearance of sexual desire might be in some people a primary PD
symptom. Needless to say impotence can have other causes and can exist
without the absence of desire. If the latter is true, it is definitly
caused by something else. In that case a visit to a doctor should be
advised.
Yet another point. As soon as a PWP is not longer a junior among us but is
raised to the status of having real on and off periods, sexual functioning
is only possible when on. Some adaptation and choosing other times for sex
can be helpfull. Another problem is motor impairment. Those problems can
mostly be solved by open discussion and creative fantasy.
I hope nobody is too shocked by this Dutch treatment of the topic.
Ida Kamphuis, Holland
