While out with her daughter, a simple question led one woman to a profound realization.The woman — a 73-year-old mom from Missouri — tripped, and her daughter asked if she thought she might have Parkinson’s disease. She didn’t, but it got her thinking. Her husband’s handwriting had been diminishing lately. She went online and found a list of the 10 most common signs of Parkinson’s. Her husband had all but one.A neurologist later confirmed her suspicions: Her husband, 69, had Parkinson’s. And, as with every couple forced to face this progressive illness, their lives haven’t been the same since.They can’t travel like they used to. Their routines have shifted. Day-to-day life has become more challenging.So has sex.It's one facet of the diagnosis that few people talk about, she says. Yet the American Parkinson Disease Association (APDA) describes diminished sexual desire as “practically inevitable” with Parkinson’s. What makes matters worse, the woman says, is the shame that can accompany bringing it up. She and her husband requested we withhold their names to protect his medical privacy and due to the sensitive nature of the topic.Dr. Rebecca Gilbert, a neurologist and chief mission officer at the APDA, says many couples facing Parkinson’s struggle with the toll the disease takes on their sex lives. To help, the APDA recently launched the ParkinSex kit − a book, card game and box of items aimed at helping couples explore what’s sexually possible for them amid Parkinson’s.“There are all these obstacles and all these barriers, and I think many couples sort of throw their hands up, and they say, ‘Well, this is just not going to be part of how we do things from now on,’” Gilbert says. “And that is what we wanted to kind of rally against.”What a Parkinson's diagnosis means for sexA neurological movement disorder, Parkinson's is progressive, meaning it gets worse over time, and involves both motor and non-motor symptoms. Common motor symptoms include tremors, stiffness and slow movement, while non-motor ones include anxiety, depression, sleep problems and fatigue.Many couples, Gilbert says, are hesitant to discuss the toll on their their sex lives, even with their doctors. So, many turn to online message boards, where they can be anonymous. On Reddit, people privately share their sexual experiences with the disease, provide tips for each other and offer support. Some of these posters have Parkinson’s themselves. Others are seeking guidance on how best to love someone who does.A major challenge of Parkinson’s, Gilbert says, is the disease’s variability. For some patients, sex isn’t a problem at all. For others, it’s practically impossible. For many, it’s somewhere in between.The key, Gilbert says, is to expand one’s view of sex. With Parkinson’s, intercourse may no longer be feasible. But other forms of intimacy, like touch or other sensory exploration, can still keep a couple connected and help them enjoy the erotic side of their relationship.The ADPA’s box comes with a blindfold, which can enhance the experience of other senses, Gilbert says, as well as a stone for massages. The book also offers recommendations, like taking a bath together or lighting candles, to help couples get in the right mental space.“Actual intercourse is great,” Gilbert says. “But if that isn't possible at some point … there are other ways to have an intimate and sexual relationship.”It’s also common amid Parkinson’s for many romantic relationships to involve caretaking. If this happens, Gilbert says, it’s important couples still see each other in a romantic and sexual way, even as the disease transforms aspects of their relationship.“This is a diagnosis that absolutely changes how you see yourself and how you see your future,” Gilbert says. “However, there are many, many ways that quality of life can be sustained for a very, very long time. And sometimes it takes people a while after their diagnosis to wrap their head around it and to accept this new reality.”'It's so much more than the act of sex'There’s a certain grief that comes with any chronic illness − an understanding that life will never quite be the same.One night, after sex, the Missouri woman says she and her husband had a frank conversation about a painful reality: Their world is shrinking. It makes her cry. It makes him mad.But, just as Parkinson’s has pushed them to expand their view of sex, it's also made them expand how they show love for each other. They always remember to say “thank you,” no matter how frustrated they may feel. They kiss frequently. They always say “I love you.”“You have to tell people you love them while they're here,” the woman says, “because one day they won't be.”To other couples struggling with intimacy amid chronic illnesses or Parkinson's specifically, she wants them to know they’re not alone, and they don't have to give up on sex entirely. And they certainly should not give up on each other.“It can be a very devastating disease, (but) you can still show love for each other. It may not be the way it used to be for you,” she says. "Even if it's just kissing or holding hands, you still can express love for each other, without having to go through an act that, especially these days, people see as the ultimate of ultimate. … Just do the best you can to express love for each other. It's so much more than the act of sex.”