What is sexual dysfunction?

Sexual dysfunction refers to a problem during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity. The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution. Sexual dysfunction can be caused by physical and emotional factors, or a combination of both. The side effects of some medications also can lead to sexual dysfunction.

What are the types of sexual dysfunction?

Sexual dysfunction generally is classified into four categories:

  • Desire disorders: The lack of sexual desire or interest in sex
  • Arousal disorders: The inability to become physically aroused during sexual activity, including problems achieving and maintaining an erection (erectile dysfunction)
  • Orgasm disorders: The delay or absence of orgasm (climax)
  • Pain disorders: Pain during intercourse (This mostly affects women.)

What medications can cause sexual dysfunction?

Some prescription medications and even over-the-counter drugs can have an impact on sexual functioning. Some medicines can affect libido (desire) and others can affect the ability to become aroused or achieve orgasm. The risk of sexual side effects is increased when an individual is taking several medications.

Sexual side effects have been reported with the following medications:

Non-prescription medicines

Some over-the-counter antihistamines and decongestants can cause erectile dysfunction or problems with ejaculation.

Antidepressants

  • Tricyclic antidepressants, including amitriptyline (Elavil), doxepin (Sinequan), imipramine (Tofranil), and nortriptyline (Aventyl, Pamelor)
  • Monoamine oxidase inhibitors (MAOIs), including phenelzine (Nardil) and tranylcypromine (Parnate)
  • Antipsychotic medications, including thioridazine (Mellaril), thiothixene (Navane), and haloperidol (Haldol)
  • Anti-mania medications such as lithium carbonate (Eskalith, Lithobid)
  • Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil).

The following medications may cause erectile dysfunction:

Anti-hypertensive medications (used to treat high blood pressure)

  • Diuretics, including spironolactone (Aldactone) and the thiazides (Diuril, Naturetin, and others)
  • Centrally acting agents, including methyldopa (Aldomet) and reserpine (Serpasil, Raudixin)
  • a-Adrenergic blockers, including prazosin (Minipress) and terazosin (Hytrin)
  • b-adrenergic (beta) blockers, including propranolol (Inderal) and metoprolol (Lopressor)

The following medications may decrease sexual desire:

Hormones

  • Leuprolide (Lupron)
  • Goserelin (Zoladex)

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