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Sexual problems by prescription.

If your libido has been less than lively lately, your sex life lacking enthusiasm, don't be too quick to blame age or disease. The problem may lie in medications, from diuretics to antihistamines, prescribed by your family doctor.

Prescription drugs are the culprit in one out of every four cases of impotence in males, and can account for inhibited ejaculation, difficulty getting or maintaining an erection, enlarged breasts, atrophied testicles, and infertility. Prescription-drug problems in females include low sex drive, delayed or inhibited orgasm, decreased lubrication, painful orgasm, and painful intercourse. The unexpected drug complication can jeopardize relationships, lead to divorce, and sometimes even threaten the patient's health.

Among the wide range of medications that may affect sexual functions are diuretics (water pills), antihypertensives (blood-pressure medicine), antiarrhythmics (for irregular heart-beat), antihistamines (for allergies), antiandrogens (for certain cancers), anticholinergics, ulcer medications, cancer drugs, central nervous system depressants, sedatives, hypnotics, antidepressants, monoamine oxidase inhibitors, antipsychotics, and alcohol.

For decades, "sex-offender" drugs have been prescribed for a wide range of medical problems without the patient or the doctor realizing that they were causing other problems at the same time. Even today, with all the advances in the medical field, most such drugs are still widely prescribed.

The reasons are twofold. Specific information about the sexual side effects of drugs is difficult to find. Like pieces of a puzzle, the data is scattered throughout numerous publications, anecdotal reports, small research papers, and

the clinical observations of individual cases. Physicians have no single resource for information, and no medical text is available on the subject. Then again, physicians receive little or no training in human sexuality in medical school. Some are uncomfortable dealing with the subject unless a patient brings it up. Others prefer not to mention the potential problems of certain medications for fear of precipitating a self-fulfilling prophecy.

Consequently, when it comes to medication, it is up to you, the consumer, to learn which prescription drugs cause sexual problems and what alternatives are available. It is you who should be aware of the side effects of medications you are taking in order to ensure that your physician, while caring for your health, is not inadvertently destroying your sex life. It is you who should take the initiative in discussing the matter.

Concluding that sexual problems are the result of age or disease and not related to medication is a common mistake. Not realizing that alternative drugs are available and becoming resigned to a hopeless situation is also all too common. However, when facing a sexual problem, one of the first and simplest things to consider is the sexual side effects of prescription medication.

Almost all drugs used for the treatment of depression have been reported at one time or another to have negative sexual side effects by causing central nervous system sedation, which can affect desire, erection, orgasm, and ejaculation. Therefore, any medication that affects your mind or your mood should be considered suspect until proven otherwise. Antidepressants, antianxiety drugs, anti-psychotics, MAO inhibitors, sedatives, tranquilizers, and hypnotics have all been implicated as sex-offender drugs.

Blood-pressure problems can also complicate sex by reducing blood flow to the genitals. Successful treatment of high blood pressure can reduce blood flow to the genitals even more. And, adding insult to injury, certain blood pressure medication directly interferes with sex drive, erection, lubrication and/or orgasm through their chemical action.

Drugs labeled as "sex offenders" do not cause sexual problems for all patients taking them, and "sexually innocent" drugs are not always free of all sexual consequences. It is a matter of probability versus improbability. In some cases, the problem is dose-related, meaning that reducing the dose of the drug can minimize or eliminate the sexual problem and that higher doses of the drug will make the problem worse. In other cases, the sexual problems precipitated by drugs are unrelated to the dosage level. Because of the existence of alternative medications, patients no longer have to trade their sex life for good health. With a little patience and persistence you can usually have both.
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Title Annotation:includes related material on drugs
Author:Crenshaw, Theresa L.
Publication:Saturday Evening Post
Date:Jan 1, 1992
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