Monday, 31 December 2012

Sexual side effects of medication


A shockwave went through my family the day my cousin Anna opened a chic erotic shop in town. Some people, like my aunt, tried to cover it up by saying Anna and her husband had " become franchisers ". That wasn't a lie but not exactly the whole truth either. It all became clear to everyone the day the invitations for the opening hit the doormats with a figurative loud bang.
I was pleasantly surprised, I often like it when things are a bit "different". So I took some friends and colleagues to the opening festivities and met quite a few family members there. Some shy , giggly or clearly uncomfortable. Others unexpectedly interested and curious and going through the shelving as if it were an exclusive exhibition in a trendy museum.
I observed Anna selling her products and listened to her talking in detail about sex and erotic equipment with ease as if she was Nigella Lawson in person promoting her cooking and favorite kitchen utensils.
Lots could be learned for  mental health care from the openness of my cousin. She inspired me to get the topic of sexual side effects of medication higher on the agenda.
Back at work my colleagues and I made a checklist for physical health to be used at care evaluations. Sexual side effects of medication was one of the topics and now much harder to neglect . And we encouraged colleagues to talk about it more.


There are many different types of psychotropic medications and they may cause a range of sexual side effects like decreased libido, erectile- or ejaculation dysfunction for men and decreased lubrication for women. For both men and women, the quality  of sensation may be less and the time it takes to reach an orgasm can be prolonged or completely impossible . Some medications are less likely to cause trouble. And some people may not experience any of the sexual side effects at all..
Sexual side effects can have a negative impact on lives and relationships. That makes it important to encourage and enable patients to speak about it.

People who are well informed about these side effects are often better prepared and more likely to comply with treatment. They know that side effects often decrease in time. But if not , a medication change,adjustment or additional medication can help to overcome these troubles. 

It's important that mental health professionals learn to discuss this subject more. It may take courage to overcome our own shyness. But there are many cases in which a solution can be found and lives  can be improved. That’s definitely worth the effort .

28 comments:

  1. Thanks for writing this, is really important to talk about this, I had this side effect and it's awful, it truly bothered me, no psychiatrist explained side-effects to me which made me unable to trust them and no professional cared about sexual side effects because I was not in a relationship with a man which is a really ignorant and harmful belief.

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  2. I just have to put up with the side effects. They ended our sex life and ensured that we don't have children. No one explained them to me. I've asked about them but I've received no help.

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  3. Sexual side effects are never mentioned by psychiatrists. Sometimes you can get viagra or cialis on request, but sometimes not - they are only available by prescription or (very expensive) on the street. For me, I just have to put up with them because the antidepressant that is the cause is the only one, out of dozens, that has worked. Sanity must trump sex, unfortunately.

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  4. Thank you for writing this. I hope for a day when sexual side effects are no longer an issue. It is too often made light of and not taken seriously enough. Good sex is integral to a healthy relationship & is congruent to good mental health overall. This issue has and does cause relationships to fail, (which isn't good for mental health last I remember). We need to stop being shy and talk about it, because there is a lot to talk about and so much is at stake.

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  5. Most consultants (or consultants in training) ask the same old questions, over and over again : how is your (a) sleep, (b) mood, (c) appetite ?

    If staff at that level were shy, they had all the reason of their broad medical training before that point to get over it and to talk frankly with those in their care, who have often enough been in a far more vulnerable and embarrassing position - it wasn't a great revelation to ask 'How is your sex-life? Can you get an erection? Can you achieve orgasm', but I think that their blinkered minds have largely shut things out of consideration.

    After all, they will happily put someone on medication in hospital and watch them balloon as it affects their appetite / metabolism, but not even stop to wonder whether that weight will ever come off, quite differently from how a physical-health ward would behave.

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  6. Thanks for writing this article. I'm both a sexuality educator (having presented at shops much like your cousin's) and an adult webcam model, so my sexuality is very important to me financially and passion-wise. I do hope doctors can become more comfortable speaking frankly about sexual matters. Le sigh, these are the problems of a largely sex-negative culture.

    I've recently had the experience of switching to Effexor and experiencing the undesired sexual side effects from that. Effexor seems to be helping very much with my mood, but I have struggled with this side effect, especially in my work. I'm also a pre-op trans woman, so doctors never know what to tell me about the impacts of sexual side effects on my physiology and hormonal make-up. I'm insanely frustrated by this.

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  7. In health we all know that it was not an easy daily task to take care of. Health was really important to all. I have read an article that said Herbal Incense was a helpful element to keep safe and can cure some illness.

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  8. Ah, yes ... try dopamine agonists ... this side-effect is but one of the subjects I wrote on in my book about early onset parkinsons. It's also (apparently) good for helping medical professionals understand their patients a little better.

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  9. I take risperidone and I guess I have experienced some sexual side effects some of the time. It used to bother me, but it doesn't so much anymore. I'm glad to have my sanity. Doctors don't ask about it specifically. It would be nice if they mentioned it and offered up some advice about what to do. I guess one way of getting some notice for side effects is reporting them to the MHRA. I've done this via the yellow card reporting tool.

    https://yellowcard.mhra.gov.uk/

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  10. 700mg of Quetiapine for 8 months have robbed me of my libido. It also made it relatively hard to ejaculate too. And when I do I come clear with hardly any sperm present at all. This makes me feel just about as less a man as I can possibly imagine. All this was never explained as a side effect by anyone. If they had you can bet I'd have stayed on Olanzapine. Once upon a time I would of stayed quiet about this, but when you've lost your dignity, what the hell. Will.

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  11. On 300mg quetiapine & 75mg of venlaflaxine, my libido was significantly reduced and so were my emotional responses to everything. As a chap in his early-20s this placed a major strain on my last relationship. What I didn't realise was that this is something that affects a hell of a lot of people. I spoke to my psych about it and she was terribly helpful about looking at tweaking my meds.

    I have spoken to others my age and even teens and the general trend is that many MH staff are dismissive as if it's pointless to address a libido issue with teens since their relationships aren't 'serious'. This is a onerous approach as it's all about perspective and relativity. I hope that we can get to a stage in the UK where we can openly discuss sexual dysfunction as a serious side-effect of psychiatric medication and find ways to address it and counsel both patients and their significant others.

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  12. I am very lucky in that my partner is incredibly understanding. My previous psychiatrist was very concerned (and open) about sexual side effects, but my current GP just dismisses it as a depression symptom.

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  13. Thankyou. I only noticed the side effects of sertraline after a prolonged period of taking it. I can't actually face talking to my gp about it tbh, I felt I had to choose between having side effects and coming off meds. So far I'm not too bad coping off meds but effects on sex life is something I need to sort out if I need to go back on them.

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    Replies
    1. There are meds that have less effect on your sexlife. Inform yourself about options just incase you need to get back on meds.
      Could consider to ask a pharmacist about it too.

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  14. I've been on Sertraline for years. Can't get off the stuff. When I met my future wife in 2008 I couldn't "perform"; not just side effects in truth, also anxiety as it was several years since I'd had a sexual relationship. Side effects played their part though and I was prescribed the magic blue pill by my GP, which, along with patience and support, led to a fulfilling sexual relationship. (At least in the short term...we now have two young children which has rather dampened our ardour :-/)

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  15. To be honest ill health affects sexual health. For women it is difficult to be aroused due to symptoms - this also counts for side effects having an impact in both arousal and a direct on climax. This can be very difficult for both males and females that are struggling because of this. It's encouraging that the "little blue pills" are of benefit (yay for you!!!)

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  16. It's disappointing that docs often don't even consider patients have or want to have a sex life, And solo- sex is a sex life too ! I once heard a psychiatrist say"you don't have a girlfriend so whats the problem?"
    There are more options to choose from, patients should be informed well about meds and side effects and they should have a choice, docs should find them the best med possible ( the med they would take themselves maybe ? )

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