Skip to main content

Advertisement

SpringerLink
Log in

Sexual dysfunction in the medically ill

  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

Common in the medically ill, sexual dysfunction results from disruption of one or more stages of the sexual response cycle. Increased understanding of sexual pathophysiology and the psychosocial forces whereby diseases impede normal function promotes more informed treatment choices. This review focuses on the pathophysiology, impact, and treatment options of sexual dysfunction in men and women with spinal cord injuries, multiple sclerosis, dementia, hypertension, heart disease, stroke, cancer, and HIV/AIDS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Elliott SL: Problems of sexual function after spinal cord injury. Prog Brain Res 2006, 152:387–399.

    PubMed  Google Scholar 

  2. Sipski ML, Alexander CJ, Rosen RC: Sexual response in women with spinal cord injuries: implications for our understanding of the able bodied. J Sex Marital Ther 1999, 25:11–22.

    Article  PubMed  CAS  Google Scholar 

  3. Sipski ML, Arenas A: Female sexual function after spinal cord injury. Prog Brain Res 2006, 152:441–447.

    PubMed  Google Scholar 

  4. Sipski ML: Central nervous system based neurogenic female sexual dysfunction: current status and future trends. Arch Sex Behav 2002, 31:421–424.

    Article  PubMed  Google Scholar 

  5. DeForge D, Blackmer J, Garrity C: Male erectile dysfunction following spinal cord injury: a systematic review. Spinal Cord 2006, 44:465–473.

    Article  PubMed  CAS  Google Scholar 

  6. Chancellor MB, Blaivas JG: Urological and sexual problems in multiple sclerosis. Clin Neurosci 1994, 2:189–195.

    PubMed  CAS  Google Scholar 

  7. Demirkiran M, Sarica Y, Uguz S, et al.: Multiple sclerosis patients with and without sexual dysfunction: are there any differences? Mult Scler 2006, 12:209–214.

    Article  PubMed  CAS  Google Scholar 

  8. Landtblom AM: Treatment of erectile dysfunction in multiple sclerosis. Expert Rev Neurother 2006, 6:931–935.

    Article  PubMed  CAS  Google Scholar 

  9. Schmidt EZ, Hofmann P, Niederwieser G, et al.: Sexuality in multiple sclerosis. J Neural Transm 2005, 112:1201–1211.

    Article  PubMed  CAS  Google Scholar 

  10. DasGupta R, Fowler CJ: Sexual and urological dysfunction in multiple sclerosis: better understanding and improved therapies. Curr Opin Neurol 2002, 15:271–278.

    Article  PubMed  Google Scholar 

  11. Black B, Muralee S, Rampi RR: Inappropriate sexual behaviors in dementia. J Geriatr Psychiatry Neurol 2005, 18:155–162.

    Article  PubMed  Google Scholar 

  12. Derouesne C, Guigot J, Chermat V, et al.: Sexual behavioral changes in Alzheimer disease. Alzheimer Dis Assoc Disord 1996, 10:86–92.

    Article  PubMed  CAS  Google Scholar 

  13. Burchardt M, Burchardt T, Baer L, et al.: Hypertension is associated with severe erectile dysfunction. J Urol 2000, 164:1188–1191.

    Article  PubMed  CAS  Google Scholar 

  14. Mittawae B, El-Nashaar AR, Fouda A, et al.: Incidence of erectile dysfunction in 800 hypertensive patients: a multicenter Egyptian national study. Urology 2006, 67:575–578.

    Article  PubMed  Google Scholar 

  15. Rastogi S, Rodriguez JJ, Kapur V, et al.: Why do patients with heart failure suffer from erectile dysfunction? A critical review and suggestions on how to approach this problem. Int J Impot Res 2005, 17(Suppl 1):S25–S36.

    Article  PubMed  Google Scholar 

  16. Bernardo A: Sexuality in patients with coronary artery disease and heart failure [in German]. Herz 2001, 26:353–359.

    Article  PubMed  CAS  Google Scholar 

  17. Addis IB, Ireland CC, Vittinghoff E, et al.: Sexual activity and function in postmenopausal women with heart disease. Obstet Gynecol 2005, 106:121–127.

    PubMed  Google Scholar 

  18. Billups KL: Sexual dysfunction and cardiovascular disease: integrative concepts and strategies. Am J Cardiol 2005, 96:57M–61M.

    Article  PubMed  CAS  Google Scholar 

  19. Jackson G, Rosen RC, Kloner RA, Kostis JB: The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine. J Sex Med 2006, 3:28–36.

    Article  PubMed  CAS  Google Scholar 

  20. Kostis JB, Jackson G, Rosen R, et al.: Sexual dysfunction and cardiac risk (the second Princeton consensus conference). Am J Cardiol 2005, 96:313–321.

    Article  PubMed  Google Scholar 

  21. DeBusk RF: Sexual activity in patients with angina. JAMA 2003, 290:3129–3132.

    Article  PubMed  CAS  Google Scholar 

  22. Schwarz ER, Rodriguez J: Sex and the heart. Int J Impot Res 2005, 17(Suppl 1):S4–S6.

    Article  PubMed  Google Scholar 

  23. Korpelainen JT, Nieminen P, Myllylä VV: Sexual functioning among stroke patients and their spouses. Stroke 1999, 30:715–719.

    PubMed  CAS  Google Scholar 

  24. Boldrini P, Basaglia N, Calanca MC: Sexual changes in hemiparetic patients. Arch Phys Med Rehabil 1991, 72:202–207.

    PubMed  CAS  Google Scholar 

  25. Monga TN, Lawson JS, Inglis J: Sexual dysfunction in stroke patients. Arch Phys Med Rehabil 1986, 67:19–22.

    PubMed  CAS  Google Scholar 

  26. Giaquinto S, Buzzelli S, Di Francesco L, et al.: Evaluation of sexual changes after stroke. J Clin Psychiatry 2003, 64:302–307.

    Article  PubMed  Google Scholar 

  27. Kimura M, Murata Y, Shimoda K, et al.: Sexual dysfunction following stroke. Compr Psychiatry 2001, 42:217–222.

    Article  PubMed  CAS  Google Scholar 

  28. Choi-Kwon M, Kim JS: Poststroke emotional incontinence and decreased sexual activity. Cerebrovasc Dis 2002, 13:31–37.

    Article  PubMed  Google Scholar 

  29. Pistoia F, Govani S, Boselli C: Sex after stroke: a CNS only dysfunction? Pharmacol Res 2006, 54:11–18.

    Article  PubMed  Google Scholar 

  30. Yaman O, Akand M, Gursoy A, et al.: The effect of diabetes mellitus treatment and good glycemic control on the erectile function in men with diabetes mellitus-inducted erectile dysfunction: a pilot study. J Sex Med 2006, 3:344–348.

    Article  PubMed  Google Scholar 

  31. Rutherford D, Collier A: Sexual dysfunction in women with diabetes mellitus. Gynecol Endocrinol 2005, 21:189–192.

    Article  PubMed  Google Scholar 

  32. Enzlin P, Mathieu C, Van Den Bruel A, et al.: Prevalence and predictors of sexual dysfunction in patients with type 1 diabetes. Diabetes Care 2003, 26:409–414.

    Article  PubMed  Google Scholar 

  33. Sáenz de Tejada I, Angulo J, Cellek S, et al.: Pathophysiology of erectile dysfunction. J Sex Med 2005, 2:25–39.

    Article  Google Scholar 

  34. Sun P, Cameron A, Seftel A, et al.: Erectile dysfunction—an observable marker of diabetes mellitus? A large national epidemiological study. J Urol 2006, 176:1081–1085.

    Article  PubMed  Google Scholar 

  35. Caruso S, Rugolo S, Agnello C, et al.: Sildenafil improves sexual functioning in premenopausal women with type 1 diabetes who are affected by sexual arousal disorder: a double-blind, crossover, placebo-controlled pilot study. Fertil Steril 2006, 85:1496–1501.

    Article  PubMed  CAS  Google Scholar 

  36. Toorians AW, Janssen E, Laan E, et al.: Chronic renal failure and sexual functioning: clinical status versus objectively assessed sexual response. Nephrol Dial Transplant 1997, 12:2654–2663.

    Article  PubMed  CAS  Google Scholar 

  37. Palmer BF: Sexual dysfunction in men and women with chronic kidney disease and end-stage kidney disease. Adv Ren Replace Ther 2003, 10:58–60.

    Article  Google Scholar 

  38. Ananth H, Jones L, King M, Tookman A: The impact of cancer on sexual function: a controlled study. Palliat Med 2003, 17:202–205.

    Article  PubMed  Google Scholar 

  39. Tal R, Mulhall JP: Sexual health issues in men with cancer. Oncology 2006, 20:294–304.

    PubMed  Google Scholar 

  40. Ganz PA, Rowland JH, Desmond K, et al.: Life after breast cancer: understanding women’s health-related quality of life and sexual functioning. J Clin Oncol 1998, 16:501–514.

    PubMed  CAS  Google Scholar 

  41. Schover LR: Sexuality and cancer: for the woman/man who has cancer and her/his partner [companion pamphlets]. New York: American Cancer Society; 1988.

    Google Scholar 

  42. Leenhouts GH, Kylstra WA, Everaerd W, et al.: Sexual outcomes following treatment for early-stage gynecological cancer: a prospective and cross-sectional multi-center study. J Psychosom Obstet Gynecol 2002, 23:123–132.

    Article  CAS  Google Scholar 

  43. Botteman MF, Pashos CL, Hauser RS, et al.: Quality of life aspects of bladder cancer: a review of the literature. Qual Life Res 2003, 12:675–688.

    Article  PubMed  CAS  Google Scholar 

  44. Wilmoth M: The aftermath of breast cancer: an altered sexual self. Cancer Nurs 2001, 24:278–286.

    Article  PubMed  CAS  Google Scholar 

  45. Schover L, Fouladi R, Warneke C, et al.: Defining sexual outcomes after treatment for localized prostate carcinoma. Cancer 2002, 95:1773–1785.

    Article  PubMed  Google Scholar 

  46. Brown GR, Gass G, Philbrick K: Sexual disorders and dysfunctions. In Textbook of Consultation-Liaison Psychiatry, edn 2. Edited by Wise M, Rundell JR. Washington, DC: APPI; 2002:455–475.

    Google Scholar 

  47. Goldmeier D, Kocsis A, Wasserman M: Sexual dysfunction in women with HIV. Sex Transm Infect 2005, 81:284.

    Article  PubMed  CAS  Google Scholar 

  48. Crum NF, Furtek KJ, Olson PE, et al.: A review of hypogonadism and erectile dysfunction among HIV-infected men during the pre-and post-HAART eras: diagnosis, pathogenesis, and management. AIDS Patient Care STDS 2005, 19:655–671.

    Article  PubMed  Google Scholar 

  49. Collazos J, Martinez E, Mayo J, Ibarra S: Sexual dysfunction in HIV-infected patients treated with highly active antiretroviral therapy. J Acquir Immune Defic Syndr 2002, 31:322–326.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA

    Kemuel L. Philbrick MD

Authors
  1. Kristin J. Somers MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kemuel L. Philbrick MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kemuel L. Philbrick MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Somers, K.J., Philbrick, K.L. Sexual dysfunction in the medically ill. Curr Psychiatry Rep 9, 247–254 (2007). https://doi.org/10.1007/s11920-007-0027-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11920-007-0027-5

Keywords

Search

Navigation