Summary
Drug-induced sexual dysfunction is a relatively common yet poorly understood clinical problem. The mechanisms whereby various drug classes alter sexual function remain poorly documented. An attempt has been made, based on recent advances in sexual physiology, to clarify drug-induced sexual dysfunction on the basis of possible or probable mechanisms of action. It is hoped that this approach may ultimately allow the physician to rationally select pharmacologic agents which minimize deleterious effects on libido, erection, ejaculation and orgasm.
Similar content being viewed by others
References
Ahmad S (1980) Hydralazine and male impotence (letter). Chest 78:358
Beitins IZ, Bayard F, Kowarski A, Migeon CJ (1973) The effect of ACTH administration on plasma testosterone, dihydrotestosterone and serum LH concentrations in normal men. Steroids 21:553
Bennett D (1961) Treatment of ejaculation praceox with monoamine — oxidase inhibitors (letter). Lancet II: 1309
Biron P (1979) Diminished libido with cimetidine therapy. Can Med Assoc J 121:404
Brindley G (1983) Phyiology of penile erection. Present at Annual Meeting of the American Urological Association, Las Vegas, Nevada
Bulpitt CJ, Dollery CT (1973) Side effects of hypotensive agents evaluated by a self-administered questionnaire. Br Med J 3:485
del Pozo E, Brownwell J (1979) Prolactin I. Mechanisms of control, peripheral actions and modification by drugs. Horm Res 10:143
Drugs that cause sexual dysfunction. Med Lett Drugs Therapeutics 22:108
Franks S, Jacobs HS, Nabarro JDN (1978) Hyperprolactinaemia and impotence. Clin Endocrinol 8:277
Goldstein I, Krane RJ (1983) Effects of hypotension on the hemodynamic of penile erections. Surg Forum (in press)
Goldstein I, Krane RJ, Ottesen B, Fahrenkrug J, Wagner G (1983) Vasoactive intestinal polypeptide release during pelvic nerve stimulation penile erections. Invest Urol (in press)
Green M, Berman S (1954) Failure of ejaculation produced by dibenzyline: preliminary report. Conn Med 18:30
Greenberg HR (1965) Erectile impotence during the course of tofranil therapy. Am J Psychiatry 121:1021
Gorski RA (1974) Barbiturates and sexual differentiation of the brain. In: Simmerman E, George R (eds) Narcotics and the hypothalamus. Raven Press, New York, p 197
Hyppa MT, Flack SC, Rinne OK (1975) Is l-dopa an aphrodisiac in patients with Parkinson's disease? In: Sandler M, Gessa GL (eds) Sexual behavior, pharmacology and biochemistry. Raven Press, New York, p 315
Jenkins RB, Groh RH (1970) Mental symptoms in Parkinson patients treated with l-dopa. Lancet II:177
Kedia KR, Markland C, Froley EE (1975) Sexual function following high retroperitoneal lymphadenectomy. J Urol 114:237
Kent JR, Biscohoff AJ, Arduno LJ, Mellinger GT, Byar DP, Hill M, Kozbur X (1973) Estrogen dosage and suppression of testosterone levels in patients with prostatic carcinoma. J Urol 109:858
Khan A, Camel G, Perry HM Jr (1970) Clonidine (Catapres): a new antihypertensive agent. Curr Ther Res 12:10
Klinge E, Sjastrand ND (1977) Comparative study of some isolated mammalian smooth effectors of penile erection. Acta Physiol Scand 100:354
Kolodny RC, Masters, WH, Kolodner RM, Toro G (1974) Depression of plasma testosterone levels after chronic intensive marijuana use. N Engl J Med 290:872
Kolodny RC (1978) Effects of alpha-methyldopa on male sexual function. Sex Disab 1:223
Kotin J, Wilbert DE, Verburg D, Soldinger SM (1976) Thioridazine and sexual dysfunction. Am J Psychiatry 133:82
Knarr JW (1976) Impotence from propranolol? (letter). Ann Intern Med 86:259
Langley JN, Anderson HK (1895) The innervation of the pelvic and adjoining viscera. III. The external generative organs. J Physiol 19:85
Laschet V, Laschet L (1977) Antiandrogens in the treatment of sexual deviations of men. J Steroid Biochem 6:821
Melman A, Libin M, Tendler C (1983) Effect of chronic alphamethyldopa upon sexual function in adult male rat. J Urol 129:643
Metoprolol (1978) Med Lett Drugs Ther 20:97
Metz P, Wagner G (1981) Penile circumference and erection. Urology 18:268
Miller RA (1976) Propranolol and impotence (letter). Ann Intern Med 85:682
Money J, Yankowitz R (1967) The sympathetic-inhibiting effects of the drug insmelin on human male eroticism, with a note on mellaril. J Sex Res 3:69
Newman RJ, Salerno HR (1974) Sexual dysfunction due to methyldopa (letter). Br Med J 4:106
Onesti G, Bock KD, Heimsoth V, Kim KE, Merguet P (1971) Clonidine: a new antihypertensive agent. Am J Cardiogr 28:74
Page LB, Sidd JJ (1972) Medical management of primary hypertension. Part II. N Engl J Med 286:1018
Papadopoulos C (1980) Cardiovascular drugs and sexuality. Arch Intern Med 140:1341
Petri WM (1980) Sexual effects of antidepressants and psychomotor stimulant drugs. Mod Probl Pharmacopsychiatry 15:77.
Pinta ER (1978) Treatment of obsessive homosexual pedophilic fantasies with medroxyprogesterone acetate. Biol Psychiatry 13:369
Rapp MS (1979) Two cases of ejaculatory impairment realted to phenelzine. Am J Psychiatry 136:1200
Rose LI, Underwood RH, Newmark SR, Kisch ES, Williams GH (1977) Pathophysiology of spironolactone-induced gynecomastia. Ann Intern Med 87:398
Sanchez RS, Murthy GG, Mehta J, Shreeve WW, Singh FR (1976) Pituitary-testicular axis in patients on lithium therapy. Fertil Steril 27:667
Shader RI (1964) Sexual dysfunction associated with thioridazine hydrochloride. JAMA 188:1007
Shader RI, Elkin R (1980) The effects of antianxiety and anti-psychotic drugs on sexual behavior. Mod Probl Pharmacopsychiatry 15:19
Sicuteri F (1974) Serotonin and sex in man. Pharmacol Res Commun 6:403
Sicuteri F, Delbene R, Anselmi B (1975) Aphrodisiac effect of testosterone in parachlorophenylalanine treated sexually deficient men. In: Sandler M, Gessa GL (eds) Sexual behavior pharmacology and biochemistry. Raven Press, New York, p 335
Siroky MB, Krane RJ (1979) Physiology of male sexual function. In: Krane RJ, Siroky MB (eds) Clinical neuro-urology, Little, Brown & Co, Boston, p 45
Sjostrand NO, Klinge E (1979) Principal mechanisms controlling penile retraction and protrusion in rabbits. Acta Physiol Scand 106:199
Slag MF, Morley JE, Elson MK, Trence DL, Nelson CJ, et al (1983) Impotence in medical clinic outpatients. JAMA 249:1736
Stessman J, Ben-Ishay D (1980) Chlorthalidone-induced impotence. Br Med J 281:714
Stoffer SS, Hynes KM, Jiang N, Ryan RJ (1973) Digoxin and abnormal serum hormone levels. JAMA 225:1643
Tamagna EI, Lane W, Hershman JM, Carlson HE, Sturdevant RAL, Poland RE, Rubin RT (1979) Effect of chronic metoclopramide therapy on serum pituitary hormone concentrations. Horm Res 11:161
Urry RL, Dougherty KA, Lockett ATK (1976) Age-related changes in male rat reproductive organ weights and plasma testosterone concentrations after administration of a monoamine oxidase inhibitor. Fertil Steril 27:1326
Van Thiel DH, Gavaler JS, Eagon PK, Chiao YB, Cobb CF, Lester R (1980) Alcohol and sexual function. Pharmacol Biochem Behav 13:125
Willis E, Ottesen B, Wagner G, Sundler F, Fahrenkrug J (1981) Vasoactive intestinal polypeptide release during pelvic nerve stimulation penile erection. Acta Physiol Scand 13:545
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Goldstein, I., Krane, R.J. Drug-induced sexual dysfunction. World J Urol 1, 239–243 (1983). https://doi.org/10.1007/BF00326809
Issue Date:
DOI: https://doi.org/10.1007/BF00326809