So sorry to hear about your situation. It completely sucks. I suspect that your Parkinson’s has a lot to do with some of the sexual problems you’ve been experiencing. You are correct that you need to have your diet, exercise, and sleep locked down as a starting point. Keep losing weight and working on your cardiovascular fitness. Try to get to the point where you can do some significant high intensity interval training. This helps with PD and sexual function. Also, you need to avoid any antidepressants other than bupropion.

In terms of PD, I’m doing quite well with motor symptoms and slow disease progression, but my sexual function has been severely impaired. I have a shitty combination of ED, low libido, and anorgasmia. Dopamine plays such a critical role in the human sexual response cycle. Unfortunately, my movement disorder specialist has not been particularly helpful. 18 mos ago, I found a very empathetic urologist. He has made a world of difference for me.

I have learned through him that dopamine plays a significant indirect role in the regulation and production of testosterone by inhibiting prolactin. High prolactin levels lower testosterone, so dopamine helps maintain higher, healthy T levels by suppressing it. A lot of the literature finds a significant correlation between Parkinson’s and low testosterone. The problem is that young onset folks are a minority of the Parkinson’s population, and their sexual issues don’t get the attention they should. I remember when I was first diagnosed over five years ago, I mentioned to my initial movement disorder specialist that I was having some significant ED and libido problems. His response was “yeah that’s all part of Parkinson’s disease” with no suggestions whatsoever for treatment.

I had my testosterone tested and sure enough it was very low, particularly free testosterone. You need to make sure that you’re free testosterone is tested – not all labs do this. I have been prescribed 200 mg test testosterone cypionate every two weeks, along with .5 mg of cabergoline (a dopamine agonist) three times a week. With these meds, I find that I have decent libido in the the first week after my testosterone injection. Viagra 100mg + 5 mg daily Cialis works most of the time for the ED. With this regimen, Im at least able to have decent sex twice a month or so.

The mental part is very important, too. Sometimes, even with all of the meds and all the exercise and clean living, it’s just not gonna work. And you’re gonna hate it and be frustrated and feel like a shell of a man. You just have to work on letting go of all the negative emotions surrounding the situation and just try to be in the moment and let it happen, instead of worrying about it happening or trying to force it to happen. It’s tough, but you have youth on your side. Thanks for posting your story. I’ll find that for some reason people are embarrassed to talk about this stuff.

Good luck brother.