The evidence shows that one of the most frequent non-motor symptoms and, at the same time, one of the bitterly disabling problems in males suffering from Parkinson’s disease is the complex sexual dysfunction. The beneficial effect of dopaminergic treatment on parkinsonian sexual dysfunction has been recently examined in patients treated either with L-DOPA or dopaminergic agonists, including pergolide. Pergolide is potent dopamine agonist which has been shown to be effective as an adjunctive in advanced stages of Parkinson’s disease, which can beneficially afflict the male sexual dysfunction. The presented study aimed to assess whether the latter effect of pergolide in advanced Parkinson’s disease remains stable also in the longer time period. Fourteen male patients suffering from Parkinson’s disease, each of whom had been treated with L-DOPA, and in whom additional treatment with peroral dopaminergic agonist (DA) was needed, were followed for a six-months and twelve-months period. Pergolide mesylate (Permax®) was given to each patient, and titrated to a total daily dose of 3 mg. All of the patients were taking L-DOPA. The assessments performed before the start of pergolide treatment consisted of a neurological examination, Unified Parkinson’s Disease Rating Scale (UPDRS) III and IV subscales scoring, Mini Mental State Examination (MMSE) scoring, the neuropsychological examination including Zung scale scoring to exclude depression, biochemical and hematological examinations including the examination of prolactine serum levels; and a sexological examination during which the patients filled-in the International Index of Erectile Function (IIEF) questionnaire. These examinations were repeated during the control assessments at months 1, 3, 6 and 12. ANOVA, non-parametric Friedmann’s ANOVA and Tukey post-hoc tests were used for the statistical analysis. There were statistically significant differences between the values of UPDRS III motor subscale, UPDRS IV (complications of therapy) subscale and all subscales of IIEF when months 0 and 1 were compared with the results obtained at months 3, 6 and 12. Pergolide mesylate, when added to L-DOPA, significantly improved sexual functions in younger male patients who were still interested in sexual activities in all aspects. The treatment with pergolide in these cases might be more beneficial than with short-acting PDE-5 inhibitor sildenafile, which meets several contraindications in common Parkinson’s disease male population.

        Key words: Parkinson’s disease, sexual dysfunction, pergolide