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Parkinson’s Sexually Inappropriate Behavior

Irrational Impulsive Or Inappropriate Behavior

Aggressive Behavior in People with Dementia | Linda Ercoli, PhD | UCLAMDChat

Some behavior changes are caused by damage to the brains executive functioning, which contributes to our memory, critical thinking, and self-control. When a stroke damages the areas of the brain that contribute to executive functioning, such as the frontal lobe, it can result in behavior changes such as irrational or inappropriate behavior.

Impulsiveness in particular is often associated with both frontal lobe strokes and a stroke in the temporal lobe, which plays a role in judgement and decision-making, particularly when the right side is affected.

On The Basis Of The Information So Far What Would You Expect The Mmse Score To Be

Your Colleagues Who Attended the Banner Alzheimers Institute Case Conference Answered as Follows:

A. 26-30
E. < 11 0%

Mr As MMSE score was 26/30. Mr As sentence and pentagon drawing from the MMSE are shown in Figure 1.The Montreal Cognitive Assessment is a 30-point test that assesses several cognitive domains. Because it is more challenging than the Mini-Mental State Examination, it has greater sensitivity for mild cognitive impairment and early stages of dementia. With a cutoff score < 26, the sensitivity for detecting mild cognitive impairment was 90% and the specificity was 87% . Research has demonstrated that MoCA scores are highly correlated with education. It is recommended that education be taken into account when interpreting MoCA performance, but there are no formal specific cutoff scores for lower education at this time . This test is available online at .

Male Sexual Disorders In Patients With Parkinson Disease: Treatment With Natural Remedies

Kameni Poumeni Mireille,

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Department of Animal Biology and Physiology, University of Yaounde I, Cameroon

Correspondence: Kameni Poumeni Mireille, University of Yaounde I, PO BOX 812, Yaounde, Cameroon, Tel 237 699 288 365

Received: August 25, 2017 | Published: November 24, 2017

Citation: Mireille KP, Desire DDP, Pierre K. Male sexual disorders in patients with parkinson disease: treatment with natural remedies. Adv Tissue Eng Regen Med Open Access. 2017 3:355360. DOI: 10.15406/atroa.2017.03.00061

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Causes Of Personality Changes

Grief, bad news, and disappointment can cause a normally happy person to become downtrodden. Sometimes, a persons mood can be altered for weeks or months after hearing devastating news. However, mood changes arent the same as personality changes.

However, some people experience unusual or strange behavior for years, which may occur due to an illness or injury. A person may experience a change in their demeanor after experiencing a traumatic situation or witnesses an unpleasant event.

These behavioral changes may be caused by a mental health condition, such as:

Medical conditions that cause a fluctuation in hormone levels can also cause strange or unusual behavior. These conditions include:

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Parkinsons Disease Sexual Issues For Couples

Cognitive Disorders

The demands and challenges of Parkinsons may derail a couples sexual dynamics. Issues may include:

  • The person with Parkinsons has reduced mobility, which may force them to take a more passive role in lovemaking.
  • Symptoms of Parkinsons tend to worsen at night, which may prompt the couple to sleep in separate bedrooms. This arrangement reduces opportunities for spontaneous sex.
  • The couple may have firmly established roles. Parkinsons can dramatically change each persons role and this sudden unfamiliarity may stall aspects of the relationship, including sex.
  • The way each person handles the diagnosis and daily demands of Parkinsons may cause friction. Communication problems can spill over into the bedroom.
  • Parkinsons can disrupt a couples lovemaking routine in many ways. Further problems will arise if the couple are unable or unwilling to make changes to their sexual attitudes and habits.

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Sexual Effects Of Parkinsons Medications

Sometimes persons with PD can experience a dramatic increase in sexual interest and activity. When dosages on some PD medications are too high it sometimes becomes more difficult for some people to control their impulses.

These impulse control disorders may involve things like excessive spending and gambling, but also too much interest in sexual activity. It is very important for people with PD to be aware of this and to have their healthcare provider adjust their medications at the first signs of these issues.

The medications most often related to impulse control problems are the dopamine agonists rather than levodopa, per se. The good news is that impulse control problems appear to be ‘dose-dependent, meaning that the unwanted behaviors go away when you reduce how much of the drug you are taking.

Never stop any medication, or lower your dose, without your healthcare provider’s OK.

Nature Of Hypersexuality In Dementia

As with non-demented people, the range of sexual behaviours shown by people with dementia is very wide. In a study of 40 people with dementia living in a long-term care home, Reference Zeiss, Davies and TinklenbergZeiss et al systematically observed each of the residents on nine separate 5-minute occasions, coding for each minute of observation whether a sexual behaviour was present and if so whether it was appropriate, inappropriate or ambiguous. Examples of inappropriate behaviour were: making explicit sexual comments, touching someone other than a partner on the breast or genitals, touching a partner on the breast or genitals in public, exposing breasts or genitals in public. Many behaviours were coded as ambiguous, for example being undressed outside the bedroom or bathroom, or sitting with stilled hands cupped over genitals. Of the 1800 one-minute segments coded, inappropriate behaviour occurred in 27 and ambiguous behaviours in 67 . Only 18% of the individuals ever displayed inappropriate behaviour during observation, and a similar proportion, 20%, displayed appropriate sexual behaviour. A further 28% showed ambiguous behaviour.

Boxes 1 and 2 list major factors in the aetiology of changes in sexual behaviour in dementia.

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Personality Changes In The Elderly

Minor personality changes in older adults, such as becoming more irritable or agitated, are not unusual. Extreme personality changes, such as a passive person becoming very controlling, could be a sign of dementia due to changes in the brains frontal lobe.

A 2016 study suggests that older adults have different personality traits than those of younger people. For example, neuroticism tended to increase in adults in their 80s.

Some people may revert to a younger age as they grow older. This could be a sign of depression or a way to cope with aging.

Parkinsons Disease Sexuality And Practical Suggestions

Parkinson’s Disease, Causes, Signs and Symptoms, Diagnosis and Treatment.

Every couple affected by Parkinsons has a different experience. Generally speaking, you could try to:

  • Learn about the effects Parkinsons and its treatment can have on sexuality.
  • Appreciate and recognise the emotional stress you are both going through, even if you are going through it differently. Make every effort to show love, respect, warmth and togetherness in non-sexual ways.
  • Talk frankly and openly about sexual needs. Communication is the best remedy for all types of relationship problems.
  • Experiment with different routines for example, switch lovemaking to the morning when Parkinsons symptoms tend to be less pronounced or when you have better mobility .
  • Place the emphasis on different physical expressions of lovemaking for example, foreplay, touching and kissing rather than penetration.
  • Explore and practice different, comfortable positions for successful and pleasurable penetration.
  • Adopt new sexual roles according to your and your partners abilities.
  • Find new solutions for physical stimulation .
  • Work together with medical staff to reduce the effects of medications on sexual function.

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Sex Drugs And Parkinson’s Disease

Mwiza Ushe Joel S. Perlmutter

Brain. 2013 136:371-373.

Dopaminergic therapy to relieve motor manifestations of idiopathic Parkinson’s disease may inadvertently cause inappropriate hypersexuality . Impulse control disorders that include gambling, eating and hypersexuality seem to occur more commonly with dopamine receptor agonist therapy than L-DOPA and can lead to substantial morbidity with social, psychological and legal consequences . The unregulated nature of direct dopamine receptor activation may provide potential clues to the underlying mechanisms. However, the pathophysiological basis for these behaviours remains unknown. Interestingly, dopaminergic pathways also play a key role in brain networks involved in the reward system, and pathological responses in this system may underlie addiction . Similarities between addictive behaviour and drug-induced hypersexuality in Parkinson’s disease suggest that they may share common pathological brain mechanisms. Thus investigations of brain regions and networks related to dopaminergic-induced hypersexuality in Parkinson’s disease could shed light on these potentially common underlying mechanisms and provide clues for rationale treatment. The study by Politis et al. in this issue of Brain takes an important step in this direction.

Tables

Treatment For Parkinsons Disease Can Affect Sexuality

Parkinsons is incurable, but most of the symptoms are manageable with medication or surgery. However, medication can diminish sexual desire and reduce sexual response. Medication which improves motor or physical functions is mainly taken during the waking hours, lower levels at night may also affect sexual function. Some medications may cause an increase in desire , which is a rare side effect. Talk to your doctor about treatment side effects.

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Professional Help For Couples Living With Parkinsons Disease

Remember, asking for help is a sign of strength. Suggestions include:

  • Seek assistance from a counsellor who is trained in sexual health.
  • See your doctor for information, advice and referral on any type of sexual difficulty. If you feel embarrassed, you might print out this fact sheet and highlight relevant sections for your doctor to read.
  • If you find it difficult to talk and communicate with your partner, counselling may help. Your doctor can refer you to an appropriate service.
  • Sexual dysfunction can be medically treated. For example, certain prescription drugs can stimulate an erection, while oestrogen medications or water-soluble lubricants can ease vaginal dryness.
  • Regular exercise reduces fatigue by increasing fitness and stamina. If you are not exercising already, see your doctor for guidelines on appropriate activities.
  • Some studies have found that depression affects sexuality more than the condition itself in people with Parkinsons disease. Talk to your doctor about treatment options for depression if you feel you are experiencing this.

Sexual Issues For Partners Of People Living With Parkinsons Disease

We Can Perform Early Screening for Neurodegenerative Disorders. Does ...

Parkinsons can affect the partners sexuality too. Issues may include:

  • feelings associated with their loved ones diagnosis, including fear, anxiety, depression and grief
  • coping difficulties
  • tiredness from taking on more responsibilities
  • loss of sexual interest in the partner because of Parkinsons symptoms
  • changing roles from partner to carer.

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Tips For A Better Sex Life With Parkinsons Disease

  • Communicate: Be open with your partner about your feelings and discuss your physical needs. If the topic of sex causes upset or arguments, it might be worth seeing a sex therapist.
  • Consider changing your medication: If your medication is having an impact on your sex life, talk to your doctor about an alternative treatment. Your sex life is important, so it should be given as much attention and care as your general health and wellbeing.
  • Be open with your doctor: Don’t be afraid to talk about sex with your doctor that’s what your healthcare team is there for, and they will have dealt with these types of concerns before.
  • Deal with fatigue and depression: Depression and fatigue can negatively impact your sex life, so look at ways of treating these symptoms. A combination of therapy and antidepressant medications may help, so talk to your doctor.

Parkinsons Personality Traits And Medications

People with Parkinsons tend not to smoke or to engage in other risky health behaviors until they are medicated with dopamine agonists, which are Parkinsons disease drugs that mimic the effects of dopamine in the brain.

In some people, these drugs actually lead to another personality change: the person taking them starts to take too many risks, perhaps by gambling or engaging in unusual sexual behavior. This personality turnaround may be dramatic and even could threaten the well-being of the person with Parkinsons and his or her family.

Therefore, its important to be aware of potential personality changes when starting a new drug for Parkinsons disease.

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What Are Parkinsons Delusions

Delusions are thoughts that arent grounded in reality. Theyre not as common as hallucinations, affecting only about 8 percent of people with Parkinsons disease. But they are harder to treat.

The most common delusions involve paranoia for example, the feeling that people are out to get you, or that your partner is cheating on you. Having these thoughts can lead to aggressive or even dangerous behavior.

Youll start with a visit to your doctor for an evaluation. Your doctor may diagnose you with this condition if you:

  • have had symptoms like hallucinations and delusions for at least 1 month
  • dont have another condition that could be causing these symptoms, like dementia, delirium, major depression, or schizophrenia

Not everyone with Parkinsons disease will develop psychosis. Youre more likely to have this if you:

There are two possible causes of Parkinsons psychosis:

  • changes in levels of brain chemicals like serotonin and dopamine from the disease itself
  • changes in levels of these chemicals from medications that treat Parkinsons disease

Dopamine is a chemical that helps your body move smoothly. People with Parkinsons disease have lower than normal levels of dopamine, which causes their body to move stiffly.

Drugs that treat Parkinsons improve movement by increasing dopamine levels. Yet they can sometimes cause psychosis as a side effect.

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Exploring Hypersexual Behavior In Men With Parkinsons Disease: Is It Compulsive Sexual Behavior

What is Parasomnia?

Article type: Research Article

Authors: Bronner, Gila | Hassin-Baer, Sharon

Affiliations: Department of Urology, Sexual Medicine Center, Sheba Medical Center, Tel-Hashomer, Israel | Department of Neurology, Parkinson Disease & Movement Disorders Clinic, Sheba Medical Center, Tel-Hashomer, Israel | Tel-Aviv University, Sackler School of Medicine, Tel-Aviv, Israel

Note: Correspondence to: Gila Bronner, Sexual Medicine Center, Sheba Medical Center, Tel-Hashomer 52621, Isreal. Office Tel.: +972 3 5305970 Tel.: +972 52 2590161/+972 3 6770297 Office Fax: +972 3 5303472 E-mail:

Keywords: Sexual dysfunction, hypersexuality, hypersexual behavior, compulsive sexual behavior, erectile dysfunction, Parkinsons disease, diagnosis

DOI: 10.3233/JPD-2012-012098

Journal: Journal of Parkinsons Disease, vol. 2, no. 3, pp. 225-234, 2012

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Manipulation Of Testosterone Levels

Anti-androgens, oestrogens and luteinising hormone releasing hormone agonists have been used in sexual offenders, but little is known about their use in older people with dementia. These agents decrease testosterone levels, which may reduce sexual drive . However, it is unclear how far serum testosterone correlates with hypersexual behaviour .

The secretion of testosterone is regulated by a feedback mechanism in the hypothalamuspituitarytestes axis. The hypothalamus produces gonadotrophin-releasing hormone, which stimulates the pituitary gland to produce luteinising hormone and follicle-stimulating hormone. Luteinising hormone stimulates the release of testosterone from the testes.

Circulating testosterone levels are maintained by a homoeostatic mechanism. When circulating testosterone levels decrease, an increase in production is promoted by luteinising hormone, which in turn is stimulated by LHRH. An increase in testosterone levels has an inhibitory effect on the hypothalamus and the pituitary.

Anti-androgens

The most widely used anti-androgens are medroxyprogesterone acetate and cyproterone acetate .

Medroxyprogesterone acetate

This is a potent progestogen that decreases serum testosterone levels by inhibiting luteinising hormone release through negative feedback on hypothalamic receptors, hence reducing testosterone secretion from the testes as described above.

Cyproterone acetate
Cimetidine

Oestrogens

LHRH analogues

Leuprorelin, triptorelin and goserelin

Examples Of Delusions In Pd

  • Belief: Your partner is being unfaithful.
  • Behavior: Paranoia, agitation, suspiciousness, aggression.
  • Belief: You are being attacked, harassed, cheated or conspired against.
  • Behavior: Paranoia, suspiciousness, agitation, aggression, defiance, social withdrawal.
  • Belief: Your body functions in an abnormal manner. You develop an unusual obsession with your body or health.
  • Behavior: Anxiety, agitation, reports of abnormal or unusual symptoms, extreme concern regarding symptoms, frequent visits with the clinician.
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    How Can Parkinson’s Affect Intimacy Sex And Sensuality

    Parkinsons does not always lead to problems with intimacy and sexuality, so do not assume that you will experience difficulties. But for some people problems can occur due to physical symptoms such as slowness of movement, rigidity, tremor and poor coordination, or because of emotional symptoms such as anxiety, fatigue, decreased motivation or depression.

    For many people a healthy sex life plays an important role in their quality of life and the quality of their relationship. Physical touch is important. These physical activities produce important neurotransmitters, such as oxytocin and endorphins, which may decrease stress, increase our pain threshold and contribute to the health of the person with Parkinson’s and their partner. If one partner in a relationship experiences a problem with intimacy, it is likely to impact on the sexual enjoyment of the other, reducing their motivation to engage in intimate touch or sexual activity. Consequently, resolving such difficulties can improve general satisfaction as well sexual satisfaction on both sides of the relationship.

    Over time sexual disturbances may be heightened by falling dopamine levels and by unwanted side effects of some Parkinsons medications.

    In short there are many factors that may be involved and some adjustment will almost certainly be needed for both partners over time.

    What Medications Are Used To Treat Parkinsons Disease

    Cognitive Disorders

    Medications are the main treatment method for patients with Parkinsons disease. Your doctor will work closely with you to develop a treatment plan best suited for you based on the severity of your disease at the time of diagnosis, side effects of the drug class and success or failure of symptom control of the medications you try.

    Medications combat Parkinsons disease by:

    • Helping nerve cells in the brain make dopamine.
    • Mimicking the effects of dopamine in the brain.
    • Blocking an enzyme that breaks down dopamine in the brain.
    • Reducing some specific symptoms of Parkinsons disease.

    Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinsons disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinsons disease. Levodopa is usually taken with carbidopa to allow more levodopa to reach the brain and to prevent or reduce the nausea and vomiting, low blood pressure and other side effects of levodopa. Sinemet® is available in an immediate release formula and a long-acting, controlled release formula. Rytary® is a newer version of levodopa/carbidopa that is a longer-acting capsule. The newest addition is Inbrija®, which is inhaled levodopa. It is used by people already taking regular carbidopa/levodopa for when they have off episodes .

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