From the FDA Drug Label
Male and Female Sexual Dysfunction with SSRIs Although changes in sexual desire, sexual performance and sexual satisfaction often occur as manifestations of a psychiatric disorder, they may also be a consequence of pharmacologic treatment. In particular, some evidence suggests that selective serotonin reuptake inhibitors (SSRIs) can cause such untoward sexual experiences Table 5 Adverse EventSertraline Hydrochloride TabletsPlacebo Ejaculation Failure1(Primarily Delayed Ejaculation) 14% 1% Decreased Libido26%1% Autonomic Nervous System Disorders-Frequent: impotence;
Adjustment Disorder with Disturbance of Conduct, Post-Traumatic Stress Disorder (PTSD), and Depressive Disorder with Anxiety Disorder can cause sexual dysfunction, as these conditions often involve changes in sexual desire, performance, and satisfaction.
- Key points:
- Sexual dysfunction can be a manifestation of the psychiatric disorder itself
- Selective serotonin reuptake inhibitors (SSRIs) used to treat these conditions can also cause sexual dysfunction
- Adverse events reported include ejaculation failure, decreased libido, and impotence
- The incidence of these events can be difficult to determine due to underreporting 1
From the Research
Yes, Adjustment Disorder with Disturbance of Conduct, Post-Traumatic Stress Disorder (PTSD), and Depressive Disorder with Anxiety Disorder can all cause sexual dysfunction. These mental health conditions affect mood, stress levels, and psychological well-being, which directly impact sexual function. In PTSD, trauma-related symptoms like hypervigilance and emotional numbing can interfere with intimacy and arousal, as noted in a study on PTSD treatment 2. Depression commonly causes reduced libido, difficulty achieving orgasm, and erectile dysfunction in men. Anxiety disorders may lead to performance anxiety and difficulty focusing during sexual activity. Additionally, medications used to treat these conditions, particularly selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, sertraline, and paroxetine, commonly cause sexual side effects including delayed ejaculation, anorgasmia, and decreased libido, as discussed in the context of PTSD and anxiety-related conditions 3. The underlying mechanism involves both the psychological impact of these disorders on sexual interest and function, as well as neurochemical changes affecting arousal pathways. Treatment approaches may include adjusting medications, adding medications like bupropion (which has fewer sexual side effects), or incorporating therapy specifically addressing sexual concerns alongside treatment for the primary mental health condition, considering the latest updates on psychotherapy for PTSD 2. It's also important to consider the diagnosis and treatment of adjustment disorder, as it may present with symptoms that impact sexual function, and its treatment can involve a range of therapeutic interventions 4, 5. Given the complexity and variability of these conditions, a comprehensive approach that addresses both the psychological and pharmacological aspects is crucial for managing sexual dysfunction in patients with Adjustment Disorder, PTSD, and Depressive Disorder with Anxiety Disorder.