Medications for chronic illnesses could affect sexual function in middle-aged women, according to a recent Journal of Sexual Medicine study.
Clinicians should be aware of possible sexual side effects that can make sex less satisfactory, such as decrease in libido, arousal concerns, and orgasm difficulties, the authors noted.
While medications are essential for the management of disease, they can also affect areas in the body that are important for healthy sexual function, such as the central and peripheral nervous systems. Medications can have “hormonal effects” as well, the authors noted.
At the same time, some medications treat illnesses that contribute to sexual dysfunction.
To learn more, a research team collected data from 749 women between the ages of 45 and 60 (average age 53 years) who lived in the Campinas, Brazil metropolitan area.
Each woman was interviewed at home by a trained researcher, who spent an average of 30 to 40 minutes asking questions about general, gynecological, and reproductive health, menopause experiences, and sexuality.
Questions on sexual health came from the Short Personal Experiences Questionnaire (SPEQ), which addresses libido, sexual responsiveness, sexual frequency, pain, feelings about a partner, and partner problems.
The women also provided information on the medications they took.
Sixty-nine percent of the women took medication. About 35% did so to treat cardiovascular disease. Fifteen percent took antidepressants, and 12% took anxiety medications.
On average, the women had sex about once or twice a week, but only a third of them were sexually active.
The researchers found no association between medications and total SPEQ scores, but poorer results in certain SQEQ domains were linked to certain types of drugs. (Note: Polypharmacy refers to the daily use of at least three different medications.)
| Sexual Problem | Associated drugs |
| Low libido | Antihypertensive drugs (to treat high blood pressure) |
| Low arousal | Antidepressants, drugs for bone and joint conditions, and polypharmacy |
| Low sexual satisfaction | Antidepressants, drugs for bone and joint conditions, diabetes medications, and polypharmacy |
| Orgasm difficulties | Antidepressants, drugs for bone and joint conditions, and diabetes medications |
Untreated anxiety contributed to sexual dysfunction as well, the authors said.
Women who took no medications tended to have better SPEQ scores. Hormone therapy, often prescribed to treat menopausal symptoms, appeared to protect against low sex drive.
They authors recommended caution with polypharmacy, which can increase the risk of side effects because of the way drugs interact with each other and with individual illnesses. “The benefits of the final combination of medication should outweigh the risks and should take sexual function into consideration,” they wrote.
“Encouraging a discussion with the patient about sexual function and providing strategies to manage this multifactorial problem are critical steps in good medical practice,” the authors concluded.
Resources
The Journal of Sexual Medicine
de Moraes, Anna Valéria Gueldini, MD, et al.
“Medication Use and Sexual Function: A Population-Based Study in Middle Aged Women”
(Full-text. Published online: July 17, 2019)
https://www.jsm.jsexmed.org/article/S1743-6095(19)31236-6/fulltext