Definition

Drug-induced sexual dysfunction is sexual dysfunction due to the consumption of certain drugs. Sexual dysfunction itself is a disorder that causes a person or a couple not to achieve sexual satisfaction.

Sexual function consists of the phases of desire, sexual arousal, and orgasm. Both men and women can experience disorders in one of these phases.

Causes

Drugs that can cause sexual dysfunction are:

• Antidepressants
  • Escitalopram
  • Sertraline
  • Fluoxetine
  • Venlafaxine, etc.

• Antipsychotics

Examples are aripiprazole, risperidone, paliperidone, haloperidol. Men taking antipsychotics report erectile dysfunction, decreased quality of orgasm, inhibited or retrograde ejaculation, and reduced sexual desire. Meanwhile, women will experience difficulty achieving orgasm, changes in the quality of orgasm to the point of not being able to orgasm. Pain during sexual intercourse also occurs in women.

• Drugs that act on the nervous system
  
  • Benzodiazepine group, for example lorazepam, clonazepam, diazepam.
  • The anticonvulsants, gabapentin, and topiramate have been associated with orgasmic dysfunction in both men and women, as well as decreased libido in women.

• Statins and fibrates, or drugs used to lower cholesterol levels
• Antihypertensive medicines

Examples include metoprolol, propranolol, chlorthalidone, and clonidine. Both hypertension and its treatment are associated with sexual dysfunction.

• Antiandrogen drugs

An example is spironolactone. These drugs will inhibit androgens so that they can cause decreased sexual desire, erectile dysfunction, orgasm disorders, and gynecomastia (breast enlargement in men).

• Steroids

An example is prednisone. The medication used to reduce inflammation can cause a decrease in testosterone levels, resulting in a decrease in sexual desire and erectile dysfunction.

• Contraception

Contraceptive pills can reduce blood testosterone. This is said to reduce sexual desire in women.

• Cancer therapy.
• Urination disorder medication

Medicines to treat urination disorders and benign prostate enlargement, for example, doxazosin or tamsulosin. Men with symptomatic benign prostate enlargement and urinary tract symptoms have increased sexual dysfunction.

• Illegal substances such as marijuana, alcohol, and tobacco

Risk Factor

Several factors can increase the risk of drug-induced sexual dysfunction, including:

• Age: The risk of erectile dysfunction tends to rise as people get older.

• Depression and other psychological issues can have a significant impact on sexual function.

• Existing diseases such as hypertension, diabetes, and others can affect sexual health and performance.

Symptoms

Symptoms of sexual dysfunction in men include:

• Loss of sexual desire or arousal
• Unable to achieve or maintain an erection
• Painful and prolonged erection (rare)
• Premature ejaculation or no ejaculation
• Disturbances in orgasm
• Pain during intercourse

Symptoms of sexual dysfunction in women include:

• Loss of sexual desire or arousal
• Pain during sexual intercourse due to decreased lubrication or vaginal dryness
• Disturbances in orgasm

Some people do not realize that the drugs they consume are the cause of sexual dysfunction, but some people also blame the drugs they consume as the cause of sexual dysfunction, even though it is caused by relationship problems with their partner or other stressors.

Diagnosis

Drug-induced sexual dysfunction can be diagnosed when sexual dysfunction occurs in people who take certain drugs. However, sometimes this condition is difficult to diagnose because the sexual dysfunction that occurs can also be caused by other diseases or psychological problems, such as schizophrenia and depression.

Therefore, the doctor will also ask several questions regarding interpersonal aspects and the patient's relationship with his partner in depth to rule out the possibility of sexual dysfunction caused by factors other than drugs.

Management

The sexual side effects of the above drugs are not permanent. There are many different options for treating this condition. However, do not stop taking medication without first consulting a doctor.

Therapy with a clinical psychologist who understands sexual dysfunction is the first step. Some ways doctors may consider include:

• Give the body time to adapt to the new drug or dose
• Lowering the dose of medication
• Replacing the drug with another drug that has low sexual side effects, especially in patients who are taking antihypertensive drugs
• Attend relationship counseling and overcome existing psychological problems, especially for people with mental disorders

Providing drugs to help treat these sexual side effects has become standard therapy for men. This drug is a type 5 phosphodiesterase inhibitor. This drug improves erectile dysfunction in around 70% of men with hypertension. However, this phosphodiesterase type 5 inhibitor should not be given without consulting a doctor.

In women, sildenafil has shown benefits in treating lack of lubrication and inhibited orgasm caused by certain antidepressant drugs. In addition, the use of estrogen cream in women can help overcome pain during sexual intercourse caused by thinning of the vaginal walls. If a woman who uses injectable progestogen contraception complains of sexual dysfunction, other contraceptive methods can be considered.

Complications

Someone who experiences sexual dysfunction due to drugs tends to be non-compliant with the treatment they are taking.

Apart from that, the presence of sexual dysfunction will affect the quality of a couple's relationship.

Prevention

Here are the things that can be done to prevent sexual dysfunction:

• Lose weight if you are overweight
• Reduce alcohol consumption
• Stop consuming tobacco, marijuana and other illegal substances
• Exercising
• Reduce stress and anxiety by doing deep breathing exercises, meditation and yoga

When to See a Doctor?

If you experience symptoms of sexual dysfunction that cause problems with your sexual life, you should consult a doctor. The doctor will help evaluate the cause and provide therapy to restore your sexual function.

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