Understanding medical causes of sexual problems

Many medical conditions and their treatments contribute to sexual problems in both men and women. People who develop sexual dysfunction as a result of a medicine are more likely not to stick to their treatment.

Clinical psychologist Dr Helen Conaglen and endocrinologist Associate Professor John Conaglen, both from the University of Auckland, write in the journal Australian Prescriber that it is crucial to encourage discussion between a patient and their doctor, to develop strategies to manage this problem.

“Commonly implicated drugs include medicines for high blood pressure, schizophrenia and depression,” say the authors.

Up to 70% of patients with depression have sexual problems, as do 30–80% of women and 45–80% of men with schizophrenia. Many cancer treatments can also have a negative influence on a sexual relationship.

Recreational drugs such as alcohol, narcotics, stimulants and hallucinogens affect sexual function. In the same issue of Australian Prescriber, Graeme Vernon of Austin Health in Melbourne writes that medicines can interact to cause problems (see Sex, drugs and alcohol).

There has even been the suggestion that oral contraceptives can reduce desire in women, although Drs Helen and John Conaglen write that there is little evidence to support this.

The authors write that in some cases, it’s difficult to distinguish the effects of an illness on sexual function from the effects of the medicines used for treatment.

But when sexual problems are caused by medicines, people may not want to continue their treatment.

“It’s in these cases that a conversation between the patient and their health professional is so important, as it is possible to tailor treatments for the patient and their partner,” they write.

Treatment options recommended by a health professional may include therapy with a clinical psychologist, switching to another medicine, dose reduction, or a drug holiday (having a planned break from the medicine).

To read the full article and others visit www.australianprescriber.com

Other articles in this edition of Australian Prescriber include:

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Australian Prescriber is an independent peer-reviewed journal providing critical commentary on therapeutic topics for health professionals, particularly doctors in general practice. It is published every two months and distributed to health professionals free of charge, and is also available online at www.australianprescriber.com 

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