Female Sexual Health
Medications and Illnesses that Adversely Impact Female Sexual Function

 

Illustration by Patsy
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This page will be used to present information about how health issues affect the clitoris and female sexuality. There are diseases that irritate and damage the clitoris, such as cancer and vulvitis, and prescription drugs that affect it's size and sensitivity. There are diseases and drugs that cause women to be unable to experience sexual arousal and orgasm. As more information is gathered about this topic it will be placed here on this page.

Prescription Drugs That Have an Adverse Affect on Female Sexuality

Antidepressants that activate dopaminergic (bupropion, venlafaxine), central noradrenic receptors (mirtazepine, bupropion, venlafaxine) and 5-hydroxytriptamine (5-HT) A1 and 2C receptors (nefazodone, mirtazepine) may augment sexua response. Those that activate other 5-HT receprots, prolactin and gamma-aminobutyric acid reduce sexual response."

Source: Vaginal Anatomy and Physiology by Sohail A. Siddique, MD (J Pelvic Med Surg 2003;9:263-272)

Antihypertensive agents:

Aldomet (alpha-methyldopa) Used to treat high blood pressure results in decreased libido and impaired sexual arousal in 10 to 15% of women who use it in low dosages, and up to 50% of women who use it in high dosages. Many of the drugs used to treat high blood pressure impair sexual function in women. There are numerous drugs available to treat this illness, a woman may need to try several different ones, or combinations, to find one that doesn't affect her sexuality adversely. Source: Masters and Johnson on Sex and Human Loving page 520.

"Traditional blood pressure lowering medications, like reserpine and guanethidine, often cause sexual dysfunction in men, along with dizziness and depression, and for this reason many doctors have moved away from them. Beta-blockers marketed under the names Inderal, Lopressor, Corgard, Blocadren, and Tenormin have fewer side effects, but many people who take them still complain of sexual dysfunction. In recent years calcium channel blockers, marketed as Adalat, Procardia, Calan, Isoptin, Verelan, Cardizem, Dilacor XR, and Tiazac have become more opular, in part because they have less effect on sexual function." Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 89, 91

All the drugs outlined below have been shown to cause erection
problems in men. They are also associated with sexual dysfunction in
women, including decreased libido, decreased arousal, and orgasmic disorder.

Drug Type:	Brand Names:	Prescribed For:
Beta-Adrenergic Blocker	Inderal, Lopressor, Corgard, Blocadren, Tenormin	High Blood Pressure
Calcium Channel Blocker	Adalat, Procardia, Calan, Isoptin, Verelan, Cardizem, Dilacor XR, Triazac	High Blood Pressure

Sedatives:

Librium (chlordiazepoxide) and Valium (diazepam) are tranquilizers. They can sometimes cause erectile dysfunction and anorgasmia, inability to orgasm. Source: Masters and Johnson on Sex and Human Loving page 520.

Quaalude (methaqualone) is a barbiturate. Barbiturates can depress the functions of the nervous system impairing sexual function. Source: Masters and Johnson on Sex and Human Loving page 520.

"Sedatives: These include medications like alprazolam, marketed as Xanax, and diazepam, or Valium. They are prescribed to relieve anxiety, but they can also cause a loss of sexual desire and arousal." Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 90, 92

All the drugs outlined below have been shown to cause erection
problems in men. They are also associated with sexual dysfunction in
women, including decreased libido, decreased arousal, and orgasmic disorder.

Drug Type:	Brand Names:	Prescribed For:
Antianxiety	Xanax, Valium	Anxiety

Antihistamines:

Antihistamines used to treat allergies and sinus ailments can result in drowsiness and a reduction in vaginal lubrication. Drowsiness will result in a decreased ability to stay awake for sex. Reduced lubrication can be perceived as vaginal pain during intercourse. Source: Masters and Johnson on Sex and Human Loving page 520.

Antidepressants:

Antidepressants: Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), Luvox (fluvoxamine), and Serzone (sertraline). These are all "selective serotonin reuptake inhibitors (SSRIs)". They can cause decreased sex drive and delayed orgasm. 1 to 25% of people using SSRIs report some sexual impairment. Zoloft and Luzox have the lowest reported side affects, Paxil the highest. Women may need to try one or more of these to find one that doesn't adversely affect her sexually. Antidepressants may improve a woman's desire and enjoyment of sex as she will feel less depressed and more in the mood for it. A new class of antidepressants, the first of which is MK869, are as effective as Paxil without the sexual side affects. Source: Girlfriends Magazine, December 1998, Page 18. Dr. Beth Brown.

"Antidepressants: Tricyclic antidepressants like clomipramine, marketed as Anafranil, causes sexual dysfunction in nearly half of the patients who take it. Anafranil has actually been used for premature ejaculation in men because it delays orgasm. Other tricyclics, like Elavil, Tofranil, Sinequan, and Pamelor can cause dry mouth, dizziness, constipation, and lethargy. For these reasons, many people prefer Prozac, the first of a new generation of enormously effective antidepressants that have fewer unpleasant side effects. Prozac is a selective serotonin reuptake inhibitor, or SSRI, and works by enhancing the action of the brains chemical serotonin. But Prozac, like the newer SSRI Zoloft, causes sexual dysfunction - usually delay in reaching orgasm, or an inability to reach orgasm - in as many as 60 percent of patients. Paxil, another SSRI, can cause a loss of libido." Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 90, 92

Quote: Letter to the Editor The Journal of Sexual Medicine Volume 2 Number 5 2005 Page 745 regarding Persistent Sexual Arousal Syndrome - A Response by Sandra Leiblum, PhD:

"Although recent reports suggest that the incidence of sexual side-effects is higher than previously recognized (30-40% vs. 5%), delayed rather than enhanced arousal and orgasms are reported. This is predictable, as SSRIs block nitric oxide (thereby decreasing smooth muscle relaxation and genital blood flow) as opposed to Viagra (which increase nitric oxide levels by inhibiting phosphodiesterase type 5 enzyme), and thus enhances arousal and orgasms."

"However it would be temporary in nature, as SSRIs are totally eliminated from the body (e.g., five half-lives) anywhere from 24 hours (Paxil) to two months (Prozac)."

This last statement does not take into account the long term effects of impaired sexual response on sexual performance. Repeated failed attempts at arousal and orgasm are likely to result in a secondary impairment to orgasm that is learned and psychological in nature, ultimately becoming physical in nature again. While initially the medication may result in an organic impairment to arousal and orgasm, secondary to this the user may learn they cannot experience orgasm. This learned barrier to orgasm may be difficult to overcome. For those on antidepressants who find they can no longer achieve full arousal and orgasm it may be best not to attempt to achieve this, as difficult and undesired as this may be. They may need to explore pleasure rather than orgasm, and avoid activities that result in sexual frustration. Communicating this to a partner may be even more challenging than the need and means of experiencing orgasm, as orgasm has become a measure of completeness and successfulness of a sexual experience.

All the drugs outlined below have been shown to cause erection
problems in men. They are also associated with sexual dysfunction in
women, including decreased libido, decreased arousal, and orgasmic disorder.

Drug Type:	Brand Names:	Prescribed For:
Tricyclic Antidepressant	Anafranil, Elavil, Tofranil, Sinequan, Pamelor	Depression
Selective Serotonin Reuptake Inhibitor (SRRI)	Prozac, Zoloft, Paxil	Depression

Patrick had this to say on 2/21/00:

RE: Orgasm difficulties & SSRI antidepressants (both genders)

Although you've probably heard this before, I think it's important, so I'll "repeat." Orgasm can be delayed, difficult, or impossible for people taking SSRI type antidepressants (Prozac, Luvox, Paxil, Zoloft, etc.)

Also:

• Both sex & cuddles can still be great fun for both.
  
• The overall success of these drugs can be so wonderful that it's still worth taking them.
  
• Talking with female friends has let me know that this happens to men & women in very similar ways.

As this points out, sex can be fun and enjoyable even in the absence of orgasm, for both men and women. Placing to much emphasis on orgasm can have an adverse affect on an individual or couple. Sex is much more than just orgasm.

Neuroleptics:

"These include antipsychotic drugs, like Thorazine, Haldol, and Zyprexa, which cause sexual dysfunction as well as significant emotional blunting in some patients." Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 90, 92

All the drugs outlined below have been shown to cause erection
problems in men. They are also associated with sexual dysfunction in
women, including decreased libido, decreased arousal, and orgasmic disorder.

Drug Type:	Brand Names:	Prescribed For:
Antipsychotic	Thorazine, Haldol, Zyprexa	Psychotic disorders, manic phase of manic depression, severe nausea or vomiting, preoperative sedative

Anticonvulsants:

"Antiseizure drugs, including phenobarbital, marketed as Luminal, as well as Dilantin, Mysoline, and Tegretol, can cause sexual dysfunction. " Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 90, 92

All the drugs outlined below have been shown to cause erection
problems in men. They are also associated with sexual dysfunction in
women, including decreased libido, decreased arousal, and orgasmic disorder.

Drug Type:	Brand Names:	Prescribed For:
Anticonvulsants, hypnotic	Luminal, Dilantin, Mysoline, Tegretol	Seizures

Antiulcer Drugs:

"Cimetidine, or Tagamet, was the first of a new class of highly effective ulcer drugs that are also used to treat serious heartburn. It works by blocking the secretion of stomach acid. Although side effects are not common, adverse reactions include impotence in men. We do not yet know the sexual function side effect in women." Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 90, 92

All the drugs outlined below have been shown to cause erection
problems in men. They are also associated with sexual dysfunction in
women, including decreased libido, decreased arousal, and orgasmic disorder.

Drug Type:	Brand Names:	Prescribed For:
H2 Receptor Antagonist	Tagamet	Ulcers

Anticancer Drugs:

"Tamoxifen, a drug prescribed to delay the recurrence of breast cancer that is marketed as Nolvadex, can cause vaginal bleeding, vaginal discharge, menstrual irregularities, genital itching, and depression. Patients on tamoxifin must be monitored for development of endometrial cancer." Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 91, 92

Birth Control Pills:

"Many women taking birth control pills enjoy sex far more than before because they have been freed from their fear of pregnancy. But some women who take progestin-dominant pills complain of a loss of libido and vaginal dryness because of the hormone shifts caused by the pills." Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 91, 93

The following is from a medical journal article abstract published January 2006 in the Journal of Sexual Medicine titled Impact of Oral Contraceptives on Sex Hormone-Binding Globulin and Androgen Levels: A Retrospective Study in Women with Sexual Dysfunction by Claudia Panzer, MD, Sarah Wise, MS, Gemma Fantini, MD, Dongwoo Kang, MD, Ricardo Munarriz, MD, Andre Guay, MD, FACP, FACE, and Irwin Goldstein, MD

"Sex hormone-binding globulin [SHBG] values in the "Continued-Users" were four times higher than those in the "Never-User" group... Despite a decrease in SHBG values after discontinuation of OC [Oral Contraceptive] use, SHBG levels in "Discontinued-Users" remained elevated in comparison with "Never-Users""

This says women taking oral contraceptives have four times as much SHBG in their blood and after some women in the study discontinued the use of an oral contraceptive their SHBG level did not return to a level consistent with that of women who had never used an oral contraceptive. SHBG attaches itself to the testosterone circulating in a woman's body making it ineffective, and possibly causing a decrease in sexual desire and sensitivity. The final conclusion of this research was stated as follows:

"Based on the preliminary findings of this investigation, further research is need to identify whether SHBG changes induced by OCs may or may not be completely reversible after discontinuation of OC use and whether this leads to long term sexual, metabolic, mental health changes in women."

I have heard rumors of instances of women experiencing adverse side-effects from the use of an oral contraceptive that did not go away when they stopped taking them and this study may lend credibility to those claims.

All the drugs outlined below have been shown to cause erection
problems in men. They are also associated with sexual dysfunction in
women, including decreased libido, decreased arousal, and orgasmic disorder.

Drug Type:	Brand Names:	Prescribed For:
Progestin-dominant Oral Contraceptive	Ortho 7/7/7, Cyclen, Tricyclen	Birth Control

NonSteroidal Anti-Inflammatory Drugs (NSAIDs):

Stacy had this to say about NSAIDs and rheumatoid arthritis:

I've been on a range of medications for rheumatoid arthritis over the past 11-12 years. It's been my experience that all NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) make it more difficult to reach or sustain full arousal, and all reduce natural lubrication, but not all do to the same degree. I've gathered from conversations with other women with RA that this may be a common problem, although with the majority of NSAIDs our experiences of which were worse varied considerably. Some of this was probably due to differential dosages, and to differing med schedules; but in general individual response to NSAIDs varies quite a bit. The one possible exception was Naproxen: almost all the women I've spoken with who've been on it for RA have mentioned not only these side-effects, but also that it appeared to lower desire. This is also the only one I'm aware of that lists potential sexual side-effects in its information sheet, not for women, but for men: impotence and lowered libido.

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Health Advisory!

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It has come to my attention that the birth control method Depo Provera can have a negative effect on a woman's health even though doctors do not know or believe it is a possibility. is a progesterone that is injected every twelve weeks to prevent pregnancy. Progesterone inhibits the production of estrogen. This means while a woman or teen is on Depo-Provera her estrogen levels may decrease, perhaps significantly. Estrogen is essential to the normal functioning and health of the vagina, vulva, and urinary tract. When estrogen levels decrease the vagina may develop Atrophic Vaginitis. This is a condition common among postmenopausal women. If you are using Depo Provera and you should experience any of the symptoms given below, see your doctor and make them aware of your use of Depo Provera. They may need to prescribe you estrogen, in cream and/or pill form, and discontinue your use of Depo Provera. Some women have developed serious and chronic side effects as the result of using this medication.

The possible symptoms of Atrophic Vaginitis are:

• Genital Dryness
• Itching
• Burning
• Unexplained Cuts and Tears
• Dyspareunia (Painful Vaginal Intercourse)
• Leukorrhe (Normal vaginal mucus discharge that has a yellowish or whitish color, but in increased amounts)
• Vulvar Pruritus (Vulvar Itching)
• Feeling of Pressure
• Yellow Malodorous Discharge
• Urinary Dysuria (Painful Urination)
• Hermaturia (Blood in the Urine)
• Urinary Frequency (Increased)
• Urinary Tract Infection
• Stress Incontinence

Additonal Antiestrogen medications that may cause atropic vaginitis are:

• Medroxyprogesterone (Provera and Depo Provera)
• Tamoxifen (Nolvadex)
• Danazol (Danocrine)
• Leuprolide (Lupron)
• Nafarelin (Synarel)
• Birth Control Pills containing high dosages of Progesterone.

The onset of a vaginal infection (candidiasis (yeast), trichomoniasis, or bacterial vaginosis) can cause the symptoms of atrophic vaginitis to become more serious.

None of the many websites I looked at that listed the possible side effects of Depo Provera mentioned atrophic vaginitis. Back when Depo Provera was first introduced a lab study involving monkeys uncovered this possible side effect. A subsequent study involving less than twenty women did not support this. Looks like the pharmaceutical companies were so eager to get this product into the market place they failed to do an in-depth study. As a result, many doctors have been misinformed. Other doctors, already knowing the effects of suppressing estrogen, know of the possible consequences or have learned of them as the result of the experiences of their patients.

All prescription birth control medications have potentially serious side effects, including death, as does pregnancy. When the possible side effects are listed, only the most common or likely to occur are usually presented. This means there will be a small percentage of women who suffer side effects that are not listed, except in perhaps the information distributed to doctors. (One percent of one million is 10,000; one tenth of one percent is still 1,000!!!) In addition, millions of women now use prescription birth control methods so the side effects they experience may differ from those of the mere thousands who were involved in the clinical trials. Even barrier methods of birth control have negative side effects, like allergic reactions or sensitivities. Some women are even allergic to semen, its acidic level.

There is no such thing as a perfect birth control method other than abstinence. Abstinence means you do not engage in intercourse but you can have "sex;" mutual masturbation, massage, oral sex, and what are commonly considered to be fetishes like bondage. Celibacy is where you do not have sex with a partner, only engaging in fantasies and masturbation. Keep in mind, if semen comes in contact with a teen's or woman's vulva there is a chance of pregnancy. Vaginal penetration is not necessary; sperm are very mobile and determined.

Non-Prescription Drugs That Have an Adverse
Affect on Female Sexuality

Alcohol can impair female sexual arousal even before intoxication takes place. Source: Masters and Johnson on Sex and Human Loving page 521.

Addictive narcotics such as heroin and morphine caused 27% of the 85 female addicts surveyed to experience orgasmic dysfunction, and 57% to experience decreased sexual interest. The root cause of these problems is unknown do to numerous factors that could cause addicts to experience sexual dysfunction. The sexual dysfunction could even be the root cause for the addition. Source: Masters and Johnson on Sex and Human Loving page 521.

Amphetamines and cocaine can cause sexual dysfunction in men when used in large doses or over long periods of time. One would have to assume women would also experience sexual dysfunction under these conditions, do to similar anatomy and sexual physiology. Source: Masters and Johnson on Sex and Human Loving page 522.

Marihuana caused some women to report temporary vaginal dryness resulting in painful intercourse. Source: Masters and Johnson on Sex and Human Loving page 523.

Illnesses That Adversely Affect Female Sexuality

Illnesses that affect the thyroid and adrenal glands can impact a woman's sexuality, mainly by reducing her sex drive and affecting sexual function. 40% of women with under active thyroid, and adrenal glands will experience difficulty-experiencing orgasm. Under active pituitary glands cause problems for an even greater number of women. These problems can be correct by hormonal therapy. Source: Masters and Johnson on Sex and Human Loving page 513.

A visitor had this to say:

Thought I'd put in my $0.02 worth on Repetitive Stress Injuries and masturbation. I've had bilateral tendonitis (both wrists and both elbows) for almost two years, and most anything I do with my hands can be difficult and/or painful. Sometimes I can't physically sustain repetitive motions without pain (which makes masturbation difficult), and the lovely fountain of sensation I get from some orgasms becomes painful when the sensations reach my arms. I suppose that's because the tendons in those areas are near major nerves.

This information applies to those with disabilities and illnesses. Since masturbation and partner sex usually require some form of repetitive motion, any illness or disability that impairs or prevents it will impact a woman's sexuality and pleasure. A woman in the above situation either has to rely on her partner to provide the repetitive motion, if she has one, or adapt non-sexual household items to meet her needs.

What would likely work best for her would be an electric vibrator, since it provides repetitive motion while allowing her to remain relatively motionless. A wand style vibrator may work best because of its long handle. A rechargeable vibrator may be necessary when a power cord would get in the way. She can either hold the vibrator against her body or rest the vibrator on a pillow while straddling it with her hips, allowing her body to press against the vibrator and pillow.

As discussed on the page about disabilities, a woman's disability or illness may have little impact on her sexuality and need for physical affection and sexual release, orgasm. If a woman loses control over her muscles as the result of injury or disease, her sexuality is most likely still intact. Even in severe cases a woman or teen may still need and crave physical intimacy and orgasm. These needs can be met through simple acts like bathing, body massage, and sleeping in the accompany of another. An electric vibrator can be placed in her hands or placed on a pillow for her to press against, allowing her to experience sexual pleasure and orgasm. In some cases though someone may need to hold the vibrator for her. While controversial in our society, sex can be an instrument of healing, physically and emotionally.

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