Substance Induced Sexual Dysfunction

Substance Induced Sexual Dysfunction

Substance induced sexual dysfunction can cause impaired desire.

Substance induced sexual dysfunction is different from primary sexual dysfunction as the symptoms that a patient suffers from are due to the effects of the substance taken and not due to any other condition. The sexual dysfunction is experienced due to a prescription drug or drug abuse of a substance that a person is taking. Substance induced sexual dysfunction is also experienced during the period the medication is being taken and stops after the medicine has been stopped.

This kind of sexual dysfunction can be due to a prescription medication that a patient may be taking for a general medical condition or due to a psychiatric illness. Once the medication is stopped, the dysfunction remits within a few days to a few weeks. If the dysfunction persists, it may be due to another cause and is not diagnosed as Substance Induced Sexual Dysfunction.

Diagnostic Features:

The most important feature if the substance induced sexual dysfunction is a sexual dysfunction of clinical significance that can lead to the development of interpersonal difficulties and also significant levels of distress. The symptoms depend upon the substance used, and these may range from:

  • Impaired arousal (which includes impaired lubrication or erectile dysfunction)
  • Sexual pain,
  • Impaired sexual desire
  • Impaired orgasm (which include Inability to ejaculate or prolonged ejaculation)

The complete effects and symptoms of the dysfunction can only be explained with the knowledge of the substance and its physiological effects, whether the drug has been abused, whether the dysfunction was caused due to an exposure to a toxin, or has it resulted from the use of some form of medication taken for a general medical condition. The definitive diagnosis must only be made when various sexual symptoms begin to precipitate, unlike in case of substance intoxication syndrome when the sexual symptoms are less pronounced due to the intoxication of the drug.

In case of this kind of sexual dysfunction, the symptoms are rather severe independently and hence can account for separate clinical and medical attention.

Distinguishing Factors:

There are a few factors that can distinguish Substance Induced Sexual Dysfunction from any primary sexual dysfunction and these factors are:

  • The course of duration of the symptoms is during the time the drug has been taken.
  • The time of onset of the dysfunction is after the drug has been taken.
  • The dysfunction ceases once the medication or drug abuse has been stopped.
  • There is a history of intoxication during physical examination.
  • There are laboratory findings in case of drug abuse.

Specifiers:

There are a number of specifiers in case of the condtion, which are based on the most predominant and prominent form of sexual dysfunction. Even though there is a significant amount of resemblance between a particular primary sexual dysfunction and substance induced sexual dysfunction. The following are the types of substance induced sexual dysfunction:

  • With Impaired Desire. This indicator is used in case the sexual desire is deficient or completely absent in a person and hence can be seen as a predominant feature of the dysfunction.
  • With Impaired Arousal. In case of impaired sexual arousal, which may include impaired lubrication or erectile dysfunction, is the most prominent feature of the dysfunction, this specifier is used.
  • With Impaired Orgasm. In case impaired orgasm is the most prominent feature of the substance induced sexual dysfunction, this specifier is used.
  • With Sexual Pain. If the individual complains of pain which is associated with sexual intercourse as the most prominent feature, then this specifier is used for substance induced sexual dysfunction.

Substance intoxication is the point where nearly all cases of Substance Induced Sexual Dysfunction acquire their onset.

Specific Substances:

Different types of sexual dysfunctions can be seen in an individual coexisting with intoxication caused by one or more of the following substances:

  • Hypnotics
  • Amphetamine
  • Anxiolytics
  • Cocaine
  • Opioids
  • Amphetamines
  • Sedatives

Dependence of substances, acute intoxication as well as abuse of the drug chronically all have been reported to cause a decrease in the sexual and participation, which can thus lead to the development of arousal problems for both partners.

Orgasmic disorders, lack of sexual interest and other arousal disorders have also been known to be caused by various different forms of medication which include:

  • Antidepressants
  • Antihypertensive Drugs
  • Neuroleptics
  • Histamine H2 Receptor Antagonists
  • Amoxapine
  • Anabolic Steroids
  • Antiepileptic Drugs
  • Fluphenazine
  • Trazodone

It has also been concluded that medications such as anabolic steroids as well as different antidepressant agents can induce mood changes including irritability and depression in individuals, along with symptoms of sexual dysfunction as well as a risk of the development of substance induced mood disorders. Modern studies, surveys and clinical researches have concluded that the effects of substance induced sexual dysfunction are generalized and are not restricted to particular forms of situations or stimulations.

Treatments:

The treatment of the condition can be done only if the substance abuse is stopped or if a prescribed medication is changed.

References:

www.ncbi.nlm.nih.gov/pubmed/9804444

The Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition by the American Psychiatry Association

Drug-Induced Infertility and Sexual Dysfunction: By Robert G. Forman M.D