The Effect of Diseases and Drugs on Sexual Response

Short- and long-term use of recreational drugs (such as alcohol, marijuana, cocaine, amphetamines, and psychotropic drugs) can affect sexual function. For example, alcohol use can inhibit sexual function in both the short and the long run. Amphetamines can enhance sexual desire initially, but long-term use can lead to sexual dysfunction.

Chronic and debilitating diseases can also affect sexual desire and function. The medications used to manage many chronic conditions can also affect sexual response and performance; however, it is not always possible to predict which clients will experience these effects before the medication is prescribed.

The effect of drugs on sexual function is often underemphasized by health care providers and medical researchers, and there has been significantly more research into the effects of drugs on sexual function in men than in women. Providers rarely mention the sexual side effects of the drugs that they prescribe, sometimes out of the fear that clients will be reluctant to take the medications if they know about the sexual side effects in advance. There are a number of ways that medicines can interfere with sexual function or satisfaction. Some drugs cause drowsiness, lethargy, or depression; others interfere with the chemical messengers of the brain that are critical for sexual interest and function. Some drugs interfere with the ability to achieve orgasm, while others delay or prevent ejaculation.

View a list of drugs that
affect sexual function

The following list, while not comprehensive, describes common conditions that affect sexual function. Other conditions that affect sexual function include cancer, thyroid disorder, Parkinson’s disease, chronic obstructive pulmonary disease, malnutrition, and alcoholism.

Coronary artery disease

Although more information about cardiac conditions and sex is available for men than for women, in general the risk of heart attack during sexual activity is low. During sexual activity, a person may experience arrhythmia (irregular heart beat), the heart rate may peak around 120 bpm, and blood pressure in unmedicated hypertensive men can rise to 230/140 at orgasm.

Drugs to control hypertension can cause impotence. The disease itself can cause clogging of blood vessels with fat deposits, resulting in the inability to achieve erection as blood flow is diminished. Persons with heart disease may be afraid to engage in sexual activity for fear of worsening their condition or stimulating a crisis. With medical guidance, timing of medication can be adjusted so that the extra physical exertion of sexual activity will be less stressful.

Diabetes

Diabetes can interfere with sexual function because of a reduction in blood flow, hormonal changes, zinc deficiency, increased frequency of vaginal infections, progression of the disease process, and psychological factors. Deterioration of blood vessels and the nervous system due to the disease process of diabetes can result in erectile dysfunction.

Renal failure

Men with renal failure may experience erectile difficulties caused by uremia (nitrogenous waste in the blood). Women with this condition may experience difficulty with arousal and orgasm, but the cause for this is not clear.

Stroke

Consequences of stroke may include impaired movement, poor ability to communicate, depression, and decreased self-esteem—all of which can negatively affect desire or the ability to act on desire.

Arthritis

Arthritis and the debilitating effect of chronic body pain on the person’s sense of well-being can affect sexual function in either significant or subtle ways. Afflicted individuals may experience pain with certain sexual positions.

Prostate disease

Surgery can cause erectile dysfunction and retrograde ejaculation (ejaculation into the urinary bladder). Symptoms of benign prostatic hypertrophy (BPH) are urinary, not sexual, but some of the drugs used to treat the condition may cause decreased libido, impotence, diminished energy, and breast tenderness.

Psychological conditions

A number of psychological conditions—as well as many of the drugs used to treat these conditions—may affect sexual response. For example, depression is a common cause of sexual dysfunction, particularly in older people, and a person experiencing dementia may have diminished appetite or inappropriate sexual behavior. Some of these conditions, such as dementia, may cause a partner to no longer feel sexual attraction to the affected person or to feel that acting on sexual desire will take advantage of the partner.

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