Substance/Medication-Induced Sexual Dysfunction

Prevalence

  • The prevalence and the incidence of substance/medication-induced sexual dysfunction are unclear, likely because of underreporting of treatment-emergent sexual side effects.

  • Data on substance/medication-induced sexual dysfunction typically concern the effects of antidepressant drugs. The prevalence of antidepressant-induced sexual dysfunction varies in part depending on the specific agent.

  • Approximately 25%-80% of individuals taking monoamine oxidase inhibitors, tricyclic antidepressants, serotonergic antidepressants, and combined serotonergic-adrenergic antidepressants report sexual side effects.

  • Approximately 50% of individuals taking antipsychotic medications will experience adverse sexual side effects, including problems with sexual desire, erection, lubrication, ejaculation, or orgasm.

  • Elevated rates of sexual dysfunction have been reported with high-dose opioid drugs for pain.

  • There are increased rates of decreased sexual desire, erectile dysfunction, and difficulty reaching orgasm associated with illicit substance use.

  • The prevalence of sexual problems appears related to chronic drug abuse.

  • Chronic alcohol abuse and chronic nicotine abuse are related to higher rates of erectile problems.

Symptoms

  • A clinically significant disturbance in sexual function is predominant in the clinical picture.

  • There is evidence from the history, physical examination, or laboratory findings of both:

  1. The symptoms developed during or soon after substance intoxication or withdrawal or after exposure to a medication.

  2. The involved substance/medication is capable of producing the symptoms.


  • The disturbance is not better explained by a sexual dysfunction that is not substance/medication-induced.

  • The disturbance does not occur exclusively during the course of a delirium.

  • The disturbance causes clinically significant distress in the individual.