[Sexuality and pharmacotherapy. Medication-induced disorders of sexual response and pharmacotherapeutic options for the treatment of sexual dysfunctions].
This contribution addresses two different areas of the complex relationship between pharmacotherapy and sexual function and dysfunction in men and women. As many impairments of sexual function are caused by side effects of medications, particularly psychotropic drugs, the first part of the paper describes substances and mechanisms often related to sexual dysfunction with a special focus on antidepressants and neuroleptics. While serotonin reuptake inhibitors entail a high risk of sexual dysfunction, it is often difficult to differentiate the negative impact of the drug from the impairment caused by the mental disorder itself. Ways to deal with these dysfunctions and remedial measures are discussed. In the second section, current pharmacological treatments for female and male sexual dysfunctions are reviewed. While there is no approved pharmacotherapy with established efficacy for female sexual dysfunction with the possible exception of the transdermal testosterone patch for surgically menopausal women, effective pharmacological therapies are available for male erectile disorders. In addition, testosterone substitution is the treatment of choice for hypoactive sexual desire disorders caused by hypogonadism. As sexual dysfunctions are often caused by a mixture of psychological and organic factors, treatment strategies combining pharmacological options and sex therapy are advocated.
Hartmann
Uwe
U
Medizinische Hochschule, Hannover, BRD. hartmann.uwe@mh-hannover.de
Rüffer-Hesse
C
C
D003131:Combined Modality Therapy; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012731:Sex Counseling / Q000379:methods*; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced* / Q000628:therapy*; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced* / Q000628:therapy*; D019529:Sexuality / Q000187:drug effects*; D016896:Treatment Outcome
D006728:Hormones; D011619:Psychotropic Drugs