A Pragmatic Approach to Sexual Health in Movement Disorders
Bibliographic record
Abstract
BACKGROUND: A satisfying sexual life is essential for maintaining good quality of life and healthy relationships for all individuals, including those with movement disorders and their partners. However, its significance is often overlooked in neurological clinics. METHODS: We review the literature and draw from our own experience to offer a practical approach for assessing and managing sexual health issues in patients with movement disorders. RESULTS: We begin by introducing fundamental concepts of sexual medicine, emphasizing models of sexual response that offer useful frameworks for diagnostic classification and management practices. We then address the most common sexual problems and disorders, including sexual dysfunction, sexual pain disorders, sexual compulsivity, and paraphilic behaviors, and their connections to different movement disorders. Next, we discuss assessment approaches that encompass biological, psychological, and social factors related to sexual health, including investigations for structural, vascular, or hormonal causes. Brief assessment questionnaires are also discussed. In addition to specific sexual therapeutic practices and supportive psychotherapy, we cover adjustments to pharmacological treatments related to movement disorders, as well as the use of mechanical devices. We also address the need for individualized management in specific cases, such as for patients undergoing deep brain stimulation surgery. CONCLUSION: Neurologists can play a key role in addressing sexual health concerns, considering the impact of both the disorder and its treatments. A comprehensive approach includes assessing biological, psychological, and sociocultural factors, with interventions like sexual therapy, supportive psychotherapy, pharmacological treatments and medical devices. Further research is needed to establish evidence-based treatments in this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.037 | 0.040 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.004 | 0.013 |
| Scholarly communication | 0.005 | 0.006 |
| Open science | 0.002 | 0.011 |
| Research integrity | 0.006 | 0.008 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".