Motor problems predominate in Huntington’s disease, and it is common for patients to encounter issues with sexuality. Studies have found that up to 75 percent of women and 85 percent of men with Huntington’s report difficulties in their sexual relations.
Altered sexuality in Huntington’s disease
Adults with Huntington’s commonly face a loss of interest in sex. Behavioral changes, such as apathy and depression, are part and parcel of the disease process and can lead to a decreased libido.
Less frequently, Huntington’s disease may also cause an increased sex drive and inappropriate sexual behavior. Such disinhibition is thought to be due to damage to the caudate nucleus, a deep area of the brain that controls behavior.
Some patients may be more likely to engage in risky sexual behavior, such as one-night stands or sex under the influence of alcohol or illicit substances. It is important to always ensure that safe sexual practices are upheld, including using condoms and taking oral contraceptive pills to avoid sexually transmitted diseases and unexpected pregnancies.
Physical challenges with intimacy
Adults with Huntington’s experience chronic, unpredictable, jerky movements called chorea, and this may interfere with maintaining intercourse. Medications that a patient may be taking, such as antidepressants, can also interfere with a person’s ability to achieve and maintain an erection.
These difficulties may lead to feelings of self-consciousness and guilt, caused by a perceived inability to participate fully in sexual activity, and to insecurity concerning future encounters.
Adjusting to changes in sexuality
It is a misconception that having a neurodegenerative disease means the end of a person’s sexual life. There are many ways that couples can adjust to changes in sexuality brought about by disease.
Sudden changes in a previously good sex life can be confusing for both partners. Open, honest communication between couples can help to clearly set sexual needs, limits, and expectations, as well as to lessen the taboo nature of the topic.
As chorea can cause difficulties during intercourse, it can be helpful to experiment so as to determine the position that best allows the partner with Huntington’s to be stable and well-supported. Couples can also be creative in finding different ways of being intimate, such as touching and caressing. Sexuality, and the affection it implies, extend far beyond intercourse.
The social implications of a neurodegenerative disease may cause a patient to feel frightened, isolated, and unloved. Those with Huntington’s can easily feel rejected and may need extra reassurance. Setting aside time to be together without distractions may help to improve intimacy between partners, and understanding. Seeking advice from a doctor or counselor also can often be of help.
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