Navigating Sexual Hurdles: Medication and Sexual Health
We have discussed, in previous posts, the benefit of visiting with a sex therapist. Sex therapy is a specialized form of therapy that addresses sexual concerns, functioning, relationship, and expression in men and women. A certified sex therapist has had considerable training in the physiological process of human sexuality, as well as, extensive training in psychotropic medications and their effect on sexual functioning. As a rule, we work collaboratively with other health care providers, such as dieticians, pelvic pain specialists, and physicians, enabling us to provide a comprehensive, multidisciplinary approach to sexual, emotional, and spiritual healing.
Part of taking a holistic approach to sexual health, is understanding the relationship between medication and sexual functioning. If you or your spouse find you are experiencing changes in your sexual functioning, it’s important to first rule out any side effects of prescribed medications. Having an awareness of possible sexual side effects from prescription medication can help to normalize thoughts and feelings, increase compassion for each other, and provide support for the sexual hurdles that couples may face at different seasons of their lives.
Over the years, our physical and/or emotional health may lead us to take prescription medication that affects our sexual health. Common drugs that may affect sexual functioning are used in the treatment of depression, anxiety, psychosis and other mental health concerns. Drugs used to treat physical health conditions may also have an effect on our sexual health. For example, cholesterol lowering and statin drugs, diabetes medication, pain killers and even antihistamines can all affect sexual performance and enjoyment. Medications used to treat prostate problems, high blood pressure, and even acid reflux may impact sexual health.
Often times, it is unclear if sexual difficulties are a result of the physical condition itself, or if it is exasperated by the drug used to treat the condition. For example, if the body is experiencing physical challenges with blood flow or nerve damage, there will inevitably be challenges with sexual functioning. However, sexual side effects from the medication can only make matters worse. In order to have compassion for yourself and for your partner, it is beneficial to have a working knowledge of all the ways mental and physical conditions, and the medication used to treat them, can affect our intimate relationship.
Medicines that can affect sexual function:
Antidepressants | Main use | Possible effect on sexual function |
MAOI antidepressants (eg: moclobemide, phenelzine) | Depression | Decreased sex drive, impotence, delayed orgasm, ejaculatory disturbances |
SSRI antidepressants (eg: fluoxetine) | Depression | Decreased sex drive, impotence, delayed or absent orgasm, ejaculatory disturbances |
Tricyclic antidepressants (eg: amitriptyline) | Depression | Decreased sex drive, impotence, delayed or absent orgasm, ejaculatory disturbances |
Antiepileptics | Main use | Possible effect on sexual function |
eg: Carbamazepine | Epilepsy | Impotence |
Antihypertensives | Main use | Possible effect on sexual function |
ACE inhibitors (eg: enalapril, lisinopril) | High blood pressure, heart failure | Impotence |
Alpha-blockers (eg: prazosin, doxazosin) | High blood pressure, enlarged prostate | Impotence, ejaculatory disturbances |
Beta-blockers (eg: atenolol, propranolol and including timolol eye drops) | High blood pressure, angina, glaucoma | Impotence |
Calcium channel blockers (eg: verapamil, nifedipine) | High blood pressure, angina | Impotence |
eg: Clonidine | High blood pressure | Impotence, decreased sex drive, delayed or failure of ejaculation |
eg: Methyldopa | High blood pressure | Impotence, decreased sex drive, ejaculatory failure |
Thiazide diuretics (eg: bendroflumethiazide) | High blood pressure | Impotence |
Antipsychotics | Main use | Possible effect on sexual function |
Phenothiazines (eg: chlorpromazine, thioridazine) | Psychotic illness | Ejaculatory disturbances, decreased sex drive, impotence |
eg: Risperidone | Psychotic illness | Impotence, ejaculatory disturbances |
Cholesterol lowering medicines | Main use | Possible effect on sexual function |
Fibrates (eg: clofibrate, gemfibrozil) | High cholesterol | Impotence |
Statins (eg: simvastatin) | High cholesterol | Impotence |
Other | Main use | Possible effect on sexual function |
eg: Benzodiazepines | Anxiety and insomnia | Decreased sex drive |
eg: Cimetidine | Peptic ulcers, acid reflux disease | Decreased sex drive, impotence |
eg: Cyproterone acetate | Prostate cancer | Decreased libido, impotence, reduced volume of ejaculation |
eg: Disulfiram | Alcohol withdrawal | Decreased sex drive |
eg: Finasteride | Enlarged prostate | Impotence, decreased sex drive, ejaculation disorders, reduced volume of ejaculation |
eg: Metoclopramide | Nausea and vomiting | Decreased sex drive, impotence |
eg: Omeprazole | Peptic ulcers, acid reflux disease | Impotence |
eg: Opioid painkillers (eg morphine) | Severe pain | Decreased sex drive, impotence |
eg: Prochlorperazine | Nausea and vomiting | Impotence |
eg: Propantheline | Gut spasm | Impotence |
eg: Spironolactone | Heart failure, fluid retention | Impotence, decreased sex drive |
This information is provided to increase awareness as well as compassion within a relationship. If you have medical questions regarding yourself or someone you love, please consult with your medical provider. Another great resource is to visit with your pharmacist. A trained pharmacist, not only has extensive knowledge in the biological conditions of patients, but also the drugs used to treat those conditions.
Experiencing sexual side effects from medication to treat a mental or physical condition can be a trial in life and very frustrating. We were created as sexual beings, so when we struggle with sexual functioning, we can also struggle with our identity, many core fears may arise, and we may experience challenges within our sexual relationship. At Agape Christian Counseling Services, we are here to help you walk through and navigate different seasons of your life, including any sexual hurdles that you may face along the way.
Blessings,
Kathryn Manley, MS, LPC, CST
Individual, Family, and Marriage Counseling
Certified Sex Therapist (AASECT)