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Sexual dysfunctions are revealed by different organic and/or psychogenic factors and proceed with the addition of psychogenic reasons to almost all organic reasons. The organic/psychogenic discrimination of etiologies is crucial in sexual dysfunctions. The most important and practical way of discrimination is systematic and detailed history. The diffuse type sexual dysfunction established in elderly people should be considered primarily based on organic reasons. Furthermore alcohol/narcotics, drug abuse, the existence of somatic or systemic diseases also strengthen the possibility of organic based sexual dysfunction. The drugs and ingredients causing significant sexual side effects include: Alcohol and narcotics, antihistaminics, decongestants, diuretics, chemotherapeutics, antiulcer drugs, antihypertensives, anticonvulsants, asthmatic drugs, cardiac drugs, psychotropic drugs (antipsychotics, antidepressants, mood stabilizers, anxiolytics, sedative hypnotics), and others.
It is mostly difficult even impossible to learn about the sexual side effects of drugs by physicians. Previous studies have revealed that patients usually didn't mention the sexual side effects of drugs to their physicians. Therefore the physicians should specifically ask about the sexual side effects of drugs beside the dosage, preferred effects, and other side effects. Besides, relationship between sexual dysfunction and other diagnosis and drugs used by the patient should be considered.
There are major unfavorable results of sexual side effects including: Loss of adaptation to drug use, abandonment of drug therapy, deterioration of psychiatric or other diseases, continuation of sexual dysfunctions, and disruption of quality of life. Significant side effects exist during the medical treatment of psychiatric disorders. The mechanism of emergence of sexual dysfunction due to medication use is complicated. Sexual dysfunctions due to medications occur by the effects of medications on peripheral and central neurotransmission. Serotonin mostly reveals negative effects on sexual behavior. However, its effects can also be positive according to receptor subtype and localization. Higher prolactin levels cause sexual dysfunction. The increase in dopaminergic activity has positive effects on sexual desire. Antipsychotics, antidepressants, anxiolytics, and other psychotropic drugs mostly have negative effects on sexual desire and behavior. Psychotropic drugs like bupropion, mirtazapine, moclobemid, reboxetine, and tianeptin have little or no sexual side effects. Even dopaminergic drugs like bupropion have positive effects on sexual desire.