A2 Refereed review article in a scientific journal
Female sexual dysfunction as an adverse effect of drugs: a narrative review
Authors: Piha, Mikael O. W.; Kero, Katja; Tornio, Aleksi
Publisher: Elsevier BV
Publishing place: CLARE
Publication year: 2025
Journal: Maturitas
Journal name in source: Maturitas
Journal acronym: MATURITAS
Article number: 108623
Volume: 199
Number of pages: 5
ISSN: 0378-5122
eISSN: 1873-4111
DOI: https://doi.org/10.1016/j.maturitas.2025.108623
Web address : https://doi.org/10.1016/j.maturitas.2025.108623
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/498989183
Sexual adverse effects of drugs are common and can compromise adherence to pharmacotherapy. Drugs can disrupt any or all phases of the sexual response cycle, potentially causing significant distress, which can amount to clinically relevant sexual dysfunction. Psychotropic and neurotropic agents are the best-characterised culprits in drug-related sexual dysfunction in females, although sexual dysfunction has been defined in various ways in the relevant literature. Specifically, serotonergic antidepressants, prolactin-increasing antipsychotics, long-term opioid therapy, and enzyme-inducing antiepileptics are associated with decreased desire, arousal dysfunction, orgasmic dysfunction, and more. In addition, progestin-containing contraceptives, antioestrogenic drugs, and beta blockers appear to increase the risk of sexual dysfunction. Possible mechanisms by which drugs interfere with sexual functions include alterations in neurotransmitter systems, increases in prolactin levels, increased sedation, and inhibition of the hypothalamic-pituitary-ovarian axis. Many medical conditions themselves can also cause sexual symptoms, and these are difficult to distinguish from pharmacological sexual adverse effects. However, different drugs for the same diseases can have substantially different sexual safety profiles, which often allows the clinician to choose a less-offending alternative. In some cases, drugs can exert even long-term adverse effects on sexual function. Therefore, sexual adverse effects must be taken into consideration when weighing the benefits and risks of different treatment modalities.
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This work did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
