Sexual problems are common in both men and women. These problems take different forms including lack of desire (decreased libido), inability to achieve erection or orgasm and impaired arousal.
Medications are a common and easily treatable cause of sexual dysfunction—and these drugs are the most likely to cause problems.
- SSRI antidepressants. Sexual dysfunction reportedly occurs in over 50% of people taking the selective serotonin reuptake inhibitors (SSRI) antidepressants. This group includes paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro) and citalopram (Celexa). If you experience sexual side effects on an SSRI, ask your doctor about a decrease in dose or a non-SSRI option that may not affect libido like generic Wellbutrin (bupropion). For men, the addition of Cialis, Levitra or Viagra may also help.
- SNRI antidepressants. Used for the treatment of both depression and fibromyalgia, these meds have almost the same incidence of decreased desire, difficulty with arousal, and difficulty achieving orgasm as the SSRIs. The serotonin-norepinephrine reuptake inhibitors, the SNRIs, are Effexor (venlafaxine), Cymbalta (duloxetine), Pristiq and Savella.
- Heart meds. Sadly, over half of folks with heart failure report that sexual problems reduce their quality of life. Many heart medications can cause sexual issues, including decreased libido. Digoxin, spironolactone (Aldactone) and thiazide diuretics like chlorthalidone and hydrochlorothiazide (HCTZ) are all known offenders. Heart failure doesn’t have to impair your sex life so ask your doctor about other options here if you are having issues.
- Tamsulosin (Flomax). Yes this is mainly a man’s drug used for symptoms from an enlarged prostate but it may surprise you to know the incidence of ejaculatory disorders with tamsulosin is 11%. Propecia and Proscar (both finasteride) also have this problem but in only 9% of men taking it.
- Clonidine. This is a sympathetic blocker that comes in a patch (Catapres) or pill and is often used to lower blood pressure. Again, you have other options for blood pressure so if you are experiencing sexual side effects, speak up.
- Cimetidine (Tagamet). Sexual side effects are well known for this readily available over-the-counter medication for heartburn and GERD. You have options that don’t do this, again, just ask.