Pathologies

A healthy sexuality involves a combination of biological, psychological, interpersonal, social, and cultural factors. If one or more factors becomes weakened by a systemic illness or its prescribed medication, sexual side effects or disorders may arise. If a decrease in your sexuality is of concern to you, it is important to consider whether the underlying cause is the illness itself or the medication being prescribed to treat the illness.

 

"The management of sexuality with chronic illness or disease must include a healthy diet and regular physical activity to ensure an active, balanced lifestyle.

 

Diabetes

“Sexual concerns, including desire, arousal, and orgasmic dysfunction, are 2 to 3 times more prevalent in women with diabetes.”(1)

Diabetes inhibits the normal flow of blood throughout the body, which can affect the flow of blood to the sexual organs. Between 32%-67% of men with diabetes are affected by ejaculation disorders, including premature ejaculation.(2)

 

Maintaining a healthy diet and engaging in regular exercise is a simple and effective way to improve both physical and mental health, and keep chronic illnesses such as diabetes, breast cancer, and cardiovascular disease at bay. Smoking, excess alcohol consumption, and obesity are all associated with higher rates of sexual disorders, and can lead to the onset of chronic illnesses.

 

Multiple Sclerosis

Patients coping with multiple sclerosis (MS) commonly experience a decline in sexual interest, enjoyment and frequency. This can arise either directly as a physical consequence of the condition, indirectly as a result of the physiological and social stress of the condition, or interactively as a combination of both.

 

It is important to confront the onset of frustration, depression, and self-defeating attitudes that often arise in people coping with MS, as they can magnify the direct effects MS might have on sexual desire, arousal or activity.(3)

 

Depression

Both depression and antidepressant medications are strongly associated with sexual dysfunctions. Depression is a psychological illness, commonly associated to hormonal changes in menopausal women, that can severely decrease sexual desire, arousal, and satisfaction even if regular sexuality activity continues.(1)(4)

 

It is important to stabilize any underlying illness that may be inducing sexual side effects before taking direct measures to address sexual symptoms. The management of sexuality with chronic illness or disease must include a healthy diet and regular physical activity to ensure an active, balanced lifestyle. 

 

Medication

A variety of medications can have undesirable effects on sexuality, including decreased arousal, libido, orgasm, and ejaculation in men. At least 25% of sexual concerns are considered to be associated with medication side effects.(1)

 

Two common pharmacological treatments associated with sexual disorders are:

  • Antidepressants/ psychoactive drugs

  • Hormonal contraception

 

Antidepressants

Antidepressant medication, particularly SSRIs, cause desire, arousal and orgasm problems in up to 70% of medication users.(6) In fact, sexual side effects are the leading reason why patients do not adhere to the pharmacological treatment of depression.

 

Unwanted side effects on sexual function and orgasm may be reversed or reduced by switching medications, temporarily stopping medication, or reducing drug dosages. If this concerns you, talk to your doctor about alternative solutions.(1)

 

Contraceptives

Oral contraception is an effective and common medication for preventing pregnancy, but it is also among the drug-related causes of androgen insufficiency in women, which often causes a decrease in sexual libido and vaginal lubrication.(1)(7)

 

If you are taking prescribed medication and are experiencing negative sexual side effects talk to your healthcare provider about the possibility of making a change in medication. Sex therapy may also relieve minor distress.

 

Lubricants and moisturizers are an effective way to alleviate minor symptoms of dryness and decreased interest and arousal. Talk to your healthcare professional today about the right solution for you.

  1. Female Sexual Health Consensus Clinical Guidelines, the Society of Obstetricians and Gynaecologist of Canada, August 2012, V34:8:2
  2. MD Brock G., Erectile Dysfunction, Canadian Diabetes Association, April 2013. V37, pg 150-152
  3. Barrett, F.M., Sexuality and Multiple Sclerosis, multiple sclerosis society of canada. 1982
  4. De Sutter P., La sexualité des gens heureux, les arène. 2009
  5. Basson R., Women’s Sexual Dysfunction: revised and expanded definitions, CMAJ May 10, 2005 V172 No. 10
  6. MD Keller, J.M., MD Gaba, N.D., Sexual Dysfunction and Oral Contraceptives. September 2010, V35