Neurosexology - Guidelines for neurologists

Sexual function can be altered in patients by many neurological disorders a ffecting the cerebrum, the brain stem, the spinal cord, the spinal roots or the peripheral nerves. It can also be prominently affected in patients wit h an underlying undiagnosed neurological disease. Traditionally, practising neurologists have not paid much attention to sexual dysfunction in their p atients, partly because therapeutic possibilities were scant. Sexual dysfun ction, however, is observed in many neurological disorders, and may arise a s a primary neurogenic disorder. Although not as obviously limiting as, for instance, paresis and pain, it is most disruptive for patients' lives. Wit h emerging awareness of the primary importance of quality of life as the mo st important indicator of good patient management. and with the advent of m ore effective treatment of sexual dysfunction, it is no longer acceptable t o ignore this very important dimension of life. In this review we will present the anatomical and physiological basis of th e sexual response, the clinical approach to patients with sexual dysfunctio n, the characteristics of symptoms in neurological disorders, how to take a case history, diagnostic procedures and the treatment possibilities.