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Male Sexual Disorders in Patients with Parkinson Disease: Treatment with Natural Remedies

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Male Sexual Disorders in Patients with Parkinson Disease: Treatment with Natural Remedies Advances in Tissue Engineering and Regenerative Medicine Review Article Open Access Male sexual disorders in patients with parkinson disease: treatment with natural remedies Abstract Volume 3 Issue 2 - 2017 Parkinson’s disease (PD) is a neurodegenerative disorder caused by a progressive Kameni Poumeni Mireille, Dzeufiet Djomeni deterioration of midbrain dopamine neurons in the substantia nigra. The incidence of PD in male is higher than that in women, but psychological symptoms are as varied as Paul Desire, Kamtchouing Pierre Department of Animal Biology and Physiology, University of the motor symptoms in both gender. Psychological symptoms encompass a decrease Yaounde I, Cameroon in sexual desire with a long list of thymic, cognitive, behavioral, and neuropsychiatric complications. Their origin can be attributed to the natural course of the disease, side Correspondence: Kameni Poumeni Mireille, University of effects of treatment, or both. Clinical researches are mainly focused on the dominant Yaounde I, PO BOX 812, Yaounde, Cameroon, Tel +237 699 288 motor symptoms of PD, but the nonmotor features of PD also need attention. Sexual 365, Email [email protected] dysfunctions (SD) are one of the most neglected nonmotor symptoms in PD. SD usually begin after the onset of motor disorders and many patients receiving DA agonists Received: August 25, 2017 | Published: November 24, 2017 as treatment manifest uncontrollable sexual desire, playing thus a major role in the deterioration of the life’s quality of patients and their partners. Research articles were retrieved from PubMed and Google using relevant keywords. Overall, this review emphasize on the sexual disorders widely reported in patients with PD and the types of natural products that are potential future supplementary agents in their control. Keywords: hyper sexuality, erectile dysfunction, plants, aphrodisiac, neuroprotective Abbreviations: PD, parkinson’s disease; ED, erectile dysfunc- progresses, leading thus to an increasing demand of Levodopa tion; HS, hypersexuality; NADH, nicotinamide adenine dinucleotide; administration.13 The resulting insatiable supply of DA is linked to 6-OHDA, 6-hydroxydopamine; MPTP, 1,2,3,6-methyl-phenyl-te- many undesirable side effects, which compromise the benefits and trahydropyridine; MAO, monoamine oxidase limit of the medical treatment. According to Bhattacharyya et al.,14 the extent of the DA agonist side effects especially on sexual function Introduction is still one of the most under recognized aspects of the condition after 200 years since the very first description by James Parkinson. Parkinson’s disease (PD) is a common neurodegenerative The focus of management is the relief of the clinically dominant movement disorder characterized by extensive degeneration of 1 motor symptoms of PD, but the non-motor features of PD also need dopamine (DA) neurons in the nigrostriatal system. It is the second attention.12 In particular, sexual disorders (SD), those are commonly most common human neurodegenerative disorder after Alzheimer’s reported in patients with PD15,16 and have attracted attention since disease and is characterized by progressive motor disability and 17 2,3 the important publication of Giovannoni et al. The incidence of SD cognitive dysfunction. PD inflicts a tremendous social and related to the increasing use of DA medication18 has been explained by economic burden on modern society due to its disabling nature and the main role of DA in sexual function. DA is a key neurotransmitter high prevalence in the aging population. Currently, the mean age of 4 in the control of sexual functions, potentially involved in both sexual onset is around 55 years. motivation and control of sexual performance.19 Clinical studies support that the incidence of PD in male is higher 5 In recent years, novel therapeutic approaches are being investigated than that in women, but psychological symptoms are as varied as the with the intention of influencing pathways leading to hinder or motor symptoms in both gender. Autonomic dysfunction symptoms alleviate PD symptoms. Some active compounds derived from plants significantly impair the quality of life of PD patients, even more than 6 have been found to exert neuroprotective, aphrodisiac and/or an motor symptoms. Autonomic dysfunctions are part of a spectrum aphrodisiac effect in PD animal models, raising the possibility that of non-motor symptoms in patients with PD.7 Nonmotor symptoms 8,9 natural products may be an effective therapeutic strategy to alleviate may precede typical motor features of PD by several years. The DA agonist side effects. The aim of this review is to report on the spectrum of nonmotor symptoms encompasses constipation, bladder impact of PD and its treatment on male sexuality, on the available anti- dysfunction, daytime somnolence, delusions/hallucinations, difficulty Parkinson agents based on natural products, and also to sum up their in concentration, dribbling, dysphagia, episodes of confusion, fatigue, therapeutic actions acting on various pathways. Overall, this review impulse control disorders, memory problems, mood disorders emphasize on the types of natural products that are potential future (depression, anxiety), orthostatic hypotension, pain, paranoia, supplementary agents in the control of sexual disorders associated to sensation of breathlessness, sleep disturbances, sweating, and also PD. sexual disorders.10,11 The conventional strategies of PD treatment are oriented towards Discussion increasing the level of the striatal DA; this is achieved either by Sexual disorders: parkinson’s disease or physiological increasing the DA precursor (levodopa) supply or by inhibiting the nature? DA breakdown by monoamine oxidase (MAO).12 However, the therapeutic dose of levodopa is adapted to the neuronal degeneration In patients with PD, sexual disorders usually begin after the onset Adv Tissue Eng Regen Med Open Access. 2017;3(2):355‒360 Submit Manuscript | http://medcraveonline.com 355 © 2017 Mireille et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Copyright: Male sexual disorders in patients with parkinson disease: treatment with natural remedies ©2017 Mireille et al. 356 of motor disorders. It can be a decrease in desire, a difficulty in the dorsomedian and the dorsolateral nucleus, which innervates the reaching orgasm and, for men, disorders of erection or ejaculation.16 bulbospongiosus and ischiocavernosus striated muscles, involved in These sexual problems can be related to age (as for PD, the risk penile rigidity in the rat.23 of developing erectile dysfunction increases after age 50) or to the Some neuroleptics have the ability to block D2 receptors in the disease itself. Indeed, dopamine plays a major role in libido and the anterior pituitary, and correlated to erectile dysfunction.24 Many occurrence of erection. As a result, the decline in dopamine production others psychoactive substances (heroin, cocaine, cannabis, alcohol) suffered by patients with PD may be associated with deterioration can stimulated the reward system provoking an increasing release in their sex lives,20 but the motor symptoms of PD like tremors, of DA. Impulse control problems have been associated to an hypertonia or akinesia (rarefaction and slowing of movements) excessive stimulation by the agonists of the D3 receptors, which are not likely to promote a satisfied sexuality. Psychological causes may stop inhibiting mechanisms behind compulsive behaviors whilst (depression and loss of self-esteem) have undoubtedly a negative stimulating reward system circuitry. Scientific research on active effect on libido. Sexual desire also disappears because the sexual ingredients blocking D3 receptors or targeting specifically D2 should function is disrupted by disappointment, frustration, and anxiety/ get more attention because their identification can improve drug depression, all main sources of mental health stress that turn off the manufacturing. libido as well sexual performances. Further, the direct and indirect effects of the disease such as loss of sexual desire does not arise of a Main sexual disorders associated to PD simple decline in sexual motivation due to age or PD, it may be also related to medications. Erectile disorders: Most men with PD consider erectile dysfunction (ED) to be the most distressing of their various disabilities imposed Impact of the treatment against PD by the disease.25 A total of 60% of men with PD reported ED, as com- pared with 37.5% in age-matched controls.26,27 Many males were also Side effects of dopamine agonists: Although the cause remains unable to ejaculate and to achieve an orgasm.10 Recent efforts to un- unknown, several pathological processes and central factors such as derstand the physiological basis underlying ED in PD have evidenced protein aggregation, mitochondrial dysfunction, iron accumulation, an unrecognized high prevalence of testosterone deficiency in elderly neuroinflammation, and oxidative stress have been reported. Cur- male patients with PD, similar to that found in the general population. rent treatment is primarily symptomatic using anti-Parkinson drugs Testosterone deficiency is also a well-documented cause of decreased namely levodopa, carbidopa, DA agonists, monoamine oxidase type libido, erectile dysfunction and decreased work performance.28 Fur- B inhibitors and anticholinergics
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