Author: Orna Moore and Gila BronnerPublished: 4 October 2017
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In the first in a series focusing on sexuality and Parkinson’s nurse consultant Orna Moore and sex therapist Gila Bronner, explain the importance of intimacy – and offer some practical strategies to promote it in a relationship where one partner has the condition
Couples who are coping with a chronic illness, such as Parkinson’s disease, have abundant needs and concerns. They face challenges and have to adapt to the changes imposed by their illness. The stress of dealing with the condition can significantly increase the burden on partners. One area that frequently goes unnoticed and un-discussed is the need to support intimacy between such couples. A lack of couple intimacy can have a devastating impact on self-esteem, relationships and the ability to cope with the disease.
We believe that it’s important for couples to spend quality time both together and apart. We have developed a practical, four-step model to help improve intimacy.
1. Couple time Couples need to spend quality time together doing things that both parties enjoy, be that going to a restaurant, seeing a film, walking, watching TV on the sofa at home or visiting friends or family.
2. Personal time Time to oneself is also important in a relationship – reading a book, taking a bath, exercising, meeting with friends, or taking a course of some kind. Couples who can allow themselves short-term separations may improve their intimacy and the need to be together.
3. Intimate time This is the time when you feel close emotionally and physically. Couples might share thoughts and feelings with the expectation that their partner listens in an empathic and understanding way. Intimate time might include physical closeness such as showering together or giving a relaxing massage, but “intimate time” should exist as an independent entity, without the pressure to move on to something more erotic.
4. Sexual (erotic) times
As you’d expect, time devoted to getting sexually aroused and trying to reach orgasm. It might include intercourse, non-penetrative outercourse or other erotic activities, such as oral or manual stimulation or mutual masturbation, which can be achieved regardless of erectile function or vaginal lubrication.
Couples need these four elements of time, even if some time passes without realising all four of them. It is important to invest in intimacy in a relationship. Couples who find it difficult to negotiate, communicate or compromise about sex and intimacy may benefit from help from an expert in couple therapy, psychology or sex therapy.
Orna Moore is a nurse consultant, working with families with neurodegenerative diseases. She works at the Department of Neurology, Tel Aviv Medical Center, Israel.
Gila Bronner is a sex therapist specialising in sexual rehabilitation. She is director of the Sex Therapy Service at the Sexual Medicine Center, Tel Aviv, and a sex therapist at the Institute of Movement Disorders, Sheba Medical Center, Israel.
More information from the European Parkinson’s Disease Association (EPDA) website
Parkinson’s does not always lead to problems with intimacy and sex, 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, tremor and poor coordination, or because of emotional symptoms such as anxiety or depression.
Men with Parkinson’s may experience erectile dysfunction and premature ejaculation that had not previously occurred, while women with Parkinson’s may now experience reduced lubrication, painful intercourse or difficulties in achieving orgasm. Over time, sexual disturbances may also be heightened by falling dopamine levels and by unwanted side effects of some Parkinson’s medications.
People with Parkinson’s often say they feel less attractive. Carers may be afraid to impose their needs for physical relationships and may refrain from initiating intimate activities. This can lead to their partner feeling more unattractive and their self-esteem is likely to be reduced. All of these difficulties can place an additional strain on relationships and some adjustment will almost certainly be needed for both parties over time. But with the right help these problems can be resolved or alleviated.
For comprehensive information about intimacy, sexuality and Parkinson’s, please visit the EPDA website.
Next week Gila and Orna discuss getting help for sexual problems
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