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What are some medicines that may affect my sexual function?

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Antidepressants, particularly SSRIs (selective serotonin reuptake inhibitors) such as fluoxetine, are the medicines most frequently implicated in causing sexual dysfunction. This is because they work by altering levels of chemicals in the brain. In particular, SSRIs increase serotonin levels, which inhibits sexual function. Blood pressure lowering (antihypertensive) medicines are the other key culprit, most probably causing sexual problems by their effect on the smooth muscle and blood vessels in the penis.

The following table lists medicines that have had sexual side effects reported in some people during their use. It is important to remember that not everyone experiences side effects with medicines. If you are at all worried that your medicine may be affecting your sexual function, it is important to discuss this with your doctor.

PRESCRIBED MEDICINE MAIN USE EFFECT ON SEXUAL FUNCTION
Antidepressants
MAOI antidepressants (eg moclobemide, phenelzine) Depression Decreased sex drive
Impotence
Delayed orgasm
Ejaculatory disturbances
SSRI antidepressants (eg fluoxetine) Depression Decreased sex drive
Impotence
Delayed orgasm
Ejaculatory disturbances
Tricyclic antidepressants (eg amitryptiline) Depression Decreased sex drive
Impotence
Ejaculatory disturbances
Antiepileptics
Carbamazepine Epilepsy Impotence
Phenytoin Epilepsy Decreased sexual potency
Antihypertensives
Alpha blockers (e.g. prazosin, doxazosin) High blood pressure
Enlarged prostate
Impotence
Beta blockers (e.g. atenolol, propranolol and including timolol eye drops) High blood pressure
Angina
Glaucoma
Impotence
Calcium channel blockers (e.g. verapamil) High blood pressure
Angina
Impotence
Clonidine High blood pressure Impotence
Decreased sex drive
Delayed or failure of ejaculation
Methyldopa High blood pressure Impotence
Decreased sex drive
Ejaculatory failure
Thiazide diuretics (e.g. bendrofluazide) High blood pressure Decreased sex drive
Impotence
Ejaculatory disturbances
Antipsychotics
Phenothiazines (e.g. chlorpromazine, thioridazine) Psychotic illness Ejaculatory disturbances
Decreased sex drive
Impotence
Risperidone Psychotic illness Impotence
Ejaculatory disturbances
Cholesterol lowering medicines
Fibrates (e.g.clofibrate, gemfibrozil) High cholesterol Impotence
Statins (e.g. simvastatin) High cholesterol Impotence
Other
Benzodiazepines Anxiety and insomnia (sleeplessness) Decreased sex drive
Cimetidine Peptic ulcers
Acid reflux disease
Impotence
Cyproterone acetate Prostate cancer Decreased libidoImpotence
Disulfiram Alcohol withdrawal Decreased sex drive
Finasteride Enlarged prostate Impotence
Decreased sex drive
Ejaculation disorders
Reduced volume of ejaculation
Omeprazole Peptic ulcers
Acid reflux disease
Impotence
Opioid painkillers (e.g. morphine) Severe pain Decreased sex drive and potency
Propantheline Gut spasm Impotence
Spironolactone Heart failure
Fluid retention
Impotence
Decreased sex drive

What can I do if I think that medicine is affecting my sexual function?

Do not stop taking your medicine without first discussing it with your doctor. Do not be put off seeking help. Remember that your quality of life is important, particularly if you are being treated for something like high blood pressure, which often has no symptoms and can require lifelong treatment. There may not always be a solution. Your doctor may try transferring you to another medicine in the same class, in the hope that the new one will not cause your side effects. Alternatively your doctor may try a different class of medicine altogether, providing it is suitable for you to take. Sometimes there may be no suitable alternatives. 

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