## Breadcrumb - [Home](/) - [Living with Parkinson's](/living-with-parkinsons) - [Management & Lifestyle](/living-with-parkinsons/management) - [Sexual Health](/living-with-parkinsons/management/sexual-health) ## Breadcrumb - [Home](/) - [Living with Parkinson's](/living-with-parkinsons) - [Management & Lifestyle](/living-with-parkinsons/management) - [Sexual Health](/living-with-parkinsons/management/sexual-health) # Female Sexual Health ## 💡 Quick Summary - Women with Parkinson’s experience an impact on their libido more than sexual performance. - PD generally does not impact fertility or childbirth, though some medications may be harmful during pregnancy. - Work with your neurologist and gynecologist to manage PD symptoms, [medications](/living-with-parkinsons/treatment/prescription-medications "Prescription Medications") and hormone therapy during pregnancy or perimenopause. ![Couple cuddling in bed](/sites/default/files/styles/no_sizing/public/images/femalesexualhealth.jpg?itok=ImRWBD3r) In women, Parkinson’s may impact libido (the desire to have sex) more than performance. Do not hesitate to address libido and other changes to female sexual health with your gynecologist. ## How can Parkinson’s influence female sexual health? - There have been no reported issues with fertility, conception or with the birthing process in women with PD. - Women with PD have a lower rate of cesarean section and a lower rate of miscarriage compared to the average American woman. - Taking levodopa during pregnancy has not been shown to have negative effects on the development of the fetus. However, taking amantadine has shown negative effects on fetal development. - The onset of PD during the perimenopausal years of hormone fluctuations can be particularly challenging because hot flashes and drenching sweat could be part of the wearing-off phenomena as well as just part of the normal symptoms of being perimenopausal. - It is important to work with a gynecologist and a neurologist to best combine hormone replacement therapy and Parkinson’s medications. ## Pregnancy & Parkinson’s About 400 women under the age of 50 are diagnosed with Parkinson’s disease (PD) in the U.S each year. It is unknown how many become pregnant. Understanding how Parkinson’s may affect pregnancy and fertility can help expectant mothers navigate this new and exciting time. ## Fertility There have been no reported issues with fertility, conception or with the birthing process in women with PD. One recent review article concluded that in women with PD there was: - a lower rate of cesarean section compared to the average American woman - a lower rate of miscarriage compared to the average rate ## Pregnancy & PD Symptoms Pregnancy may cause changes in Parkinson’s symptoms. Consult with your neurologist if you are experiencing worsening or sudden changes to your PD symptoms during pregnancy. - ### Movement Symptoms The literature on how pregnancy affects movement symptoms of PD is conflicted. - Several reports have indicated worsening of PD symptoms during pregnancy and in the postpartum period, but others have reported no change or even improvement during pregnancy. - A recent review showed that 52% of the women experienced improvement or no worsening in PD motor symptoms, with the vast majority experiencing no change in symptoms. Women taking anti-parkinsonian medications were much more likely to have improvement or no change in PD symptoms. - Possible explanations for worsening of symptoms include PD progression, changes in how PD medications are metabolized during pregnancy, the physical stress of pregnancy, or taking too little levodopa. - ### Non-movement Symptoms Little is known about how pregnancy affects non-movement symptoms in PD. Pregnancy can cause many symptoms that are also common non-movement symptoms in PD, such as: - Constipation - Dizziness - Urinary frequency - Fatigue - Disrupted sleep or insomnia - Mood changes - Muscle cramping - Restless leg syndrome ## Pregnancy & PD Medications Treatment with medications is often recommended for people living with PD, even during pregnancy. About half of women with PD who become pregnant will have worsening of their symptoms, and this risk is much higher in those who do not take any anti-parkinsonian medications. There are no standardized or placebo-controlled studies to prove safety of anti-parkinsonian medication during pregnancy. - ### Levodopa Levodopa is the PD medication with the most data. It was reported that there was no increased rate of miscarriage, birth complications or birth defects seen with the use of levodopa. - ### Dopamine Agonists There is some evidence that the use of dopamine agonists are possibly safe to use during pregnancy, but data is limited. - ### Amantadine There is strong evidence to avoid use of amantadine during pregnancy, given possible birth defects and increased risk of miscarriage with its use. Whether they have Parkinson's or not, women trying to conceive or who become pregnant should not take amantadine. - ### Other PD Medications Not enough is known about COMT (catechol-o-methyl transferase) inhibitors (entacapone) or MAO-B inhibitors (selegiline, rasagiline) to comment on their safety during pregnancy. - ### Other Treatment Options If medications are not being used for symptom control during pregnancy, then at the very least physical therapy and occupational therapy should be utilized. Consult your OB/GYN for a recommended exercise regimen. ## Breastfeeding with PD Breastfeeding while taking PD medications is typically not advised, because so little is known about secretion of these drugs into breast milk. Levodopa, amantadine, entacapone and tolcapone are excreted in breast milk and the potential effects on the infant are largely unknown. Levodopa and dopamine agonists may suppress lactation, but despite this, some women have successfully breastfed while on these medications. ## Research on PD & Pregnancy Even though Parkinson’s is less common in women, especially of childbearing age, it certainly does occur. Women in this group are an underrepresented population. There have been no formal clinical trials conducted regarding PD and pregnancy, as pregnant women are largely excluded from medication and treatment trials due to fear of effects on the fetus. Having more data and knowledge about pregnancy and PD may improve quality of life for people with PD who are of childbearing age. Collecting this data would help medical professionals develop guidelines for giving the best care during pregnancy. *Page reviewed by Dr. Tracy Tholanikunnel, Assistant Professor of Movement Disorders at the University of Florida, a Parkinson’s Foundation Center of Excellence.* - ### References 1. Rubin SM. Parkinson’s Disease in Women. *Disease-a-Month*. 2007;53(4):206-213. doi:10.1016/j.disamonth.2007.02.002 2. Subramanian I, Mathur S, Oosterbaan A, Flanagan R, Keener AM, Moro E. Unmet Needs of Women Living with Parkinson’s Disease: Gaps and Controversies. *Mov Disord*. 2022;37(3):444-455. doi:10.1002/mds.28921 3. Seier M, Hiller A. Parkinson’s disease and pregnancy: An undated review. *Parkinsonism Relat Disord*. 2017;(40):11-17. . 4. García-Ramos R, Santos-García D, Alonso-Cánovas A, et al. Management of Parkinson’s disease and other movement disorders in women of childbearing age: Part 1. *Neurol (English Ed*. 2021;36(2):149-157. doi:10.1016/j.nrleng.2020.05.015 5. Kranick SM, Mowry EM, Colcher A, Horn S, Golbe LI. Movement disorders and pregnancy: A review of the literature. *Mov Disord*. 2010;25(6):665-671. doi:10.1002/mds.23071 ## Related Blog Posts ![pregnancy fertitlity blog](/sites/default/files/styles/500x360/public/images/pregnancyfertitlity-blog.png?h=c12e0b96&itok=ArB_1vpc) Raise Awareness ### [ Pregnancy and Fertility with Parkinson’s ](/blog/awareness/pregnancy-fertility) READ NOW ![3 generations of women](/sites/default/files/styles/500x360/public/images/pdqanda-talktochildren-blog.jpg?h=c12e0b96&itok=h_deHgrE) Raise Awareness ### [ Parkinson's Q&A: How do I talk to my children about Parkinson's disease? ](/blog/awareness/children) READ NOW ![Two women hiking together ](/sites/default/files/styles/500x360/public/images/unmetwomensneeds-blog-2.png?h=5193ff8a&itok=30lUZ3OF) Science News ### [ The Unmet Needs of Women with Parkinson’s ](/blog/science-news/women) READ NOW ## Related Materials Fact Sheets ### [ Intimacy and PD ](/library/fact-sheets/intimacy) [Read Now](/library/fact-sheets/intimacy) Podcasts ### [ Episode 63: Navigating Sexuality and Intimacy with PD ](/library/podcast/63) [Listen Now](/library/podcast/63) Podcasts ### [ Episode 131: Addressing the Unmet Needs of Women with PD ](/library/podcast/131) [Listen Now](/library/podcast/131) ### Parkinson's Foundation Helpline Contact 1-800-4PD-INFO or Helpline@Parkinson.org for answers to your Parkinson’s questions. 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