The Side Effects of Medications

: What medications have sexual side effects?

There are many factors that can have an adverse impact on sexuality, both interest in sex and sexual performance, and many of these apply to both men and to women. One of the more common medications that we prescribe in our society are referred to as SSRIs. These are a group of anti-depressant medicines that are very, very effective, or can be very effective in dealing with a very painful condition known as unipolar depression, but one of the side effects of the SSRIs, and it's universal, is that it either decreases interest in sex, decreases the ability to have either an orgasm or an ejaculation, and a little less so, on the impact of actually having an erection. However, if you're not interested, it's hard to have an erection, because that's part of the process, you gotta be interested.

And as a class, they affect the sexual area. We're struggling a little bit to try and see if we can reverse this and all of us have strategies that we've developed, either lowering the dose, adding another agent to counteract it, but they're not perfect. On the other hand, depression is not a disease that you can leave untreated. And I think that's where the dilemma is.

: Are there other medications that impact sexual performance?

Some of the birth control pills may have an effect; usually not as striking as the SSRIs obviously. Blood pressure medicines especially the beta blockers, diuretics, the old kinds of medications that we used to use, aldomet, reserpine all these older drugs all had a major effect.

The newer generation of blood pressure medicines have much less. If anything, they may have some pro sexual effects, the ACEs and the ARBs are pretty much sexually neutral, but I think,… and we know that alcohol can certainly have a depressive effect on sexual performance. Antihistamines in theory could have an inhibiting effect, not necessarily that powerfully, but anything can have an impact on… One of the things I always ask a patient that comes in with sexual issues are what medicines are they taking. Sometimes it's just the medicine, rather than themselves that is the problem.