Background Huntington's disease results in a wide variety of physical, mental, and social disabling impairments that will affect sexuality. Up to 85% men and up to 75% women experience high levels of sexual problems (Schmidt and Bonelli, 2007). Most prevalent is low sexual desire, but also increased sexual interest and paraphilia are found. Specific brain lesions might be associated with these changes, but also psychosocial factors with a steadily worsening disease might be causative. Depression and anxiety, common symptoms in early stages of HD, are often associated with sexual symptoms. Change in sexual interest and behaviour, sexual dysfunction, and socio-psychiatric consequences of HD cause suffering also for spouses and children.

Aims Sexological rehabilitation is aiming at promoting well-being both in patient and the partner.

Methods/techniques Bio-psycho-social approaches have been useful in sexological support and rehabilitation in people with chronic neurological impairments. Sexual rehabilitation follows the basics of the PLISSIT model (Annon, 1976). Acceptance and Commitment Therapy is a treatment option.

Results/outcome There might be a need of comprehensive management and treatment of sexual complications in HD. Special training and experience in sexology is mandatory for professional counselling and support.

Conclusions HD brings suffering in connection to sexuality. Sexual problems often reduce life satisfaction in patients and partners. The whole family situation can be affected. Professional attention should be given to the sexual symptoms in HD. Clinical sexology knowledge and skills should be developed. Sexological rehabilitation requires a broad focus on bodily changes, identity questions, as well as relationship challenges and adjustments.