Neurological Diseases and Sexual Dysfunction: How Do They Affect Sexual Function?
Neurological diseases compromise nerves and neurotransmitters, potentially causing erectile dysfunction, such as in multiple sclerosis. Understand the relationship between neurological diseases and sexual dysfunction.
Neurological diseases affect the nervous system, and the brain may not respond to sexual stimuli or send the correct signals for the genitals to prepare for intercourse. Learn more about neurological diseases and sexual dysfunction.
How Do Neurological Diseases Affect Sexual Function?
The central nervous system is formed by the brain and spinal cord, whose function is to process sensory information. The peripheral nervous system connects the central nervous system with the rest of the body.
Therefore, the sexual response can be impaired if these structures are disrupted. See why neurological diseases and sexual dysfunction are closely related:
1. Nerve Function Alterations
In cases of spinal cord injuries, communication between the brain and the genital organ is affected, which is why erectile dysfunction and low libido are common in this scenario.
2. Hormonal Changes
Multiple sclerosis and Parkinson’s disease affect the production of testosterone, the hormone responsible for regulating male sexual function. Since the brain also plays a role in hormone production, brain lesions may reduce testosterone levels and lead to sexual dysfunction.
3. Circulatory Problems
After a stroke, blood circulation to various organs, including sexual organs, is compromised. Therefore, men who have had a stroke may experience erectile dysfunction.
4. Motor Difficulties
Parkinson’s disease includes symptoms such as tremors and lack of motor coordination, which limit freedom of movement, making the sexual act more challenging.
5. Urinary and Fecal Incontinence
Urinary incontinence and fecal incontinence are common in neurological diseases and congenital neuropathies, such as myelomeningocele, a malformation of the spine and spinal cord during gestation.
This lack of control arises because the nervous system mechanisms that regulate urination and defecation do not function properly, causing emotional discomfort in intimate situations.
Main Neurological Diseases Related to Sexual Function
Check out the five main neurological diseases that can lead to sexual dysfunction:
- Multiple Sclerosis;
- Parkinson’s Disease;
- Spinal Cord Injury;
- Epilepsy;
- Peripheral Neuropathy.
Multiple Sclerosis
In multiple sclerosis, the immune system attacks neurons, affecting their structure and communication.
Although not fully understood, it is believed that genetic and environmental factors play a role. Exposure to the Epstein-Barr virus, smoking, exposure to organic solvents, and vitamin D deficiency are among the factors that increase the risk of this condition. Symptoms include:
- Fatigue;
- Loss of bladder control;
- Blurred vision;
- Facial pain or burning sensation;
- Loss of balance and strength;
- Numbness in the legs;
- Tingling in the extremities;
- Muscle spasms;
- Weakness;
- Nasal-sounding speech;
- Dizziness or vertigo.
Regarding the impact of multiple sclerosis on sexual function, this article cites studies indicating that 50–90% of men experienced sexual dysfunction at some point, with low libido, erectile dysfunction, and ejaculatory disorders being the main issues.
Parkinson’s Disease
Parkinson’s disease affects the area of the brain responsible for processing information and controlling movements. It is caused by a gradual reduction of dopamine, a substance involved in regulating motor activities such as walking, speaking, and writing. Symptoms include:
- Slowness of motor activities;
- Muscle stiffness;
- Hand or finger tremors, usually at rest;
- Loss of balance;
- Frequent urge to urinate;
- Constipation;
- Excessive sweating and salivation;
- Anxiety and depression;
- Sleep disturbances.
According to this article, erectile dysfunction and premature ejaculation are common in men with Parkinson’s. The same publication also explains that the treatment for erectile dysfunction in Parkinson’s patients may involve antidepressants (in cases of premature ejaculation) and selective phosphodiesterase inhibitors for erection problems.
Stroke (CVA)
A stroke can be caused by the rupture of a blood vessel or an obstruction of an artery.
A ruptured blood vessel in the brain is called a hemorrhagic stroke because it causes bleeding in the brain tissue or between the brain and the meninges, the membrane that covers and protects the central nervous system.
When the artery is obstructed, it is classified as an ischemic stroke, characterized by a lack of oxygen to the brain cells, which then die.
Stroke symptoms include:
- Mental confusion;
- Difficulty speaking or understanding speech;
- Vision changes in one or both eyes;
- Sudden, severe headache;
- Dizziness, loss of balance, and difficulty walking;
- Weakness on one side of the body, possibly affecting the face, leg, or arm.
Regarding the influence of a stroke on sexual health, erectile dysfunction can occur because the condition may permanently compromise blood circulation. However, according to this article, loss of self-esteem, anxiety, and depression also affect sexuality after a stroke.
Alzheimer’s Disease
Alzheimer’s disease involves the loss of neurons, caused by the accumulation of toxic proteins, family history, vascular problems, aging, and lifestyle factors such as smoking, physical inactivity, and poor diet. Warning signs include:
- Memory loss;
- Mental confusion;
- Difficulty reasoning and planning tasks;
- Inability to care for oneself;
- Urinary and fecal incontinence;
- Trouble speaking, moving, and swallowing.
The connection between dementia and libido is explored in this article. It emphasizes the importance of finding nonsexual forms of intimacy, such as massage and dancing.
The same material also explains that some individuals with Alzheimer’s may experience hypersexuality, which is an excessive interest in sex. In such cases, the person may resort to excessive masturbation.
Brain or Spinal Cord Trauma
Brain and spinal cord traumas can be caused by traffic accidents, falls, sports injuries, or blows to the head or spine.
These injuries interfere with communication between the brain and the genitals, leading to loss of sensation, reduced libido, and erectile dysfunction.
Specifically about traumatic brain injury, this literature review mentioned issues such as difficulty achieving erections, ejaculatory problems, and decreased sexual activity in men who had been sexually active before the injury and later experienced intimacy challenges.
The same study indicates that managing sexual dysfunction in neurological diseases often requires a multidisciplinary approach. Various studies suggest that combining medication, sexual rehabilitation, and psychological counseling can positively impact treatment outcomes and patient quality of life.
Various studies suggest that a multidisciplinary approach—potentially including medications, sexual rehabilitation, and psychological support—can be beneficial for managing sexual dysfunction in neurological disease patients.
Causes of Erectile Dysfunction in Neurological Patients
Erectile dysfunction in neurological patients results from a failure of communication between the brain, spinal cord, and the penis. The causes include:
- Spinal cord injuries caused by trauma or disease;
- Neurological diseases such as multiple sclerosis, Parkinson’s disease, stroke, and Alzheimer’s disease;
- Surgeries in the pelvic region or spine that damage nerves or blood vessels;
- Reduced levels of neurotransmitters like dopamine and serotonin in certain neurological conditions.
Physical and Emotional Impacts on Sexual Life
Neurological diseases affect the communication between the brain, spinal cord, and genital organs. This leads to sexual dysfunctions such as loss of sensation, difficulty achieving erections, and reduced libido.
These changes can impact emotional connection with a partner and, in some cases, contribute to anxiety or depression. Psychological counseling for sexual dysfunction in neurological diseases is essential to help couples overcome these challenges.
Available Treatments and Therapeutic Approaches
Treating sexual dysfunction resulting from neurological diseases can involve several strategies, such as:
- Medications to improve blood flow to the penis;
- Hormone replacement therapy;
- Exercises to strengthen the pelvic floor;
- Therapy with a psychologist or sex therapist;
- Nerve stimulation therapy for sexual dysfunction using low-intensity electric currents to stimulate the nerves.
Tips to Improve Quality of Life and Intimacy
Simple habits can boost your quality of life and improve intimacy. Check them out:
- Open communication with your partner;
- Healthy eating habits;
- Regular physical exercise;
- Stress management;
- Seeking professional help for emotional concerns.
Neurological diseases bring changes to sexual life that should be addressed by a multidisciplinary team. Take the first step with a pre-assessment with Dr. Paulo Egydio.
If you have questions about sexual dysfunction related to neurological diseases, getting an individualized medical evaluation is essential.
