Sexual dysfunction in men taking systemic dermatologic medication: A systematic review

J Am Acad Dermatol. 2019 Jul;81(1):163-172. doi: 10.1016/j.jaad.2019.03.043. Epub 2019 Mar 21.

Abstract

Background: Prescription medications are among the most common causes of sexual dysfunction, and patients are often hesitant to seek help when experiencing these symptoms.

Objective: In this review, we identify the available evidence of sexual adverse effects in men using systemic dermatologic medications and suggest screening protocols and actions that may improve a patient's symptoms where possible.

Methods: A systematic review was conducted of all articles in the PubMed database published from the time of inception to May 2018 to identify studies evaluating the use of systemic dermatologic medications in men with evidence of sexual adverse effects. Subsequently, a secondary in-depth literature review was performed for each individual medication.

Results: There were 5497 articles reviewed in the primary systematic review, and 59 articles covering 11 systemic dermatologic medications met inclusion criteria. We identified level 1 evidence for sexual adverse effects as a primary outcome in patients taking finasteride.

Limitations: Many included studies were limited by sample size and methodology.

Conclusion: The information in this review may serve as a reference of adverse effects when deciding on a therapeutic agent and a guide to help identify patients to screen for sexual dysfunction.

Keywords: anorgasmia; ejaculation dysfunction; erectile dysfunction; impotence; libido; sexual dysfunction; systemic medications.

Publication types

  • Systematic Review

MeSH terms

  • Adrenal Cortex Hormones / adverse effects*
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Age Factors
  • Cyclosporine / adverse effects
  • Cyclosporine / therapeutic use
  • Dermatologic Agents / adverse effects*
  • Dermatologic Agents / therapeutic use*
  • Finasteride / adverse effects*
  • Finasteride / therapeutic use
  • Humans
  • Itraconazole / adverse effects*
  • Itraconazole / therapeutic use
  • Male
  • Middle Aged
  • Prevalence
  • Prognosis
  • Risk Assessment
  • Sexual Dysfunction, Physiological / chemically induced*
  • Sexual Dysfunction, Physiological / epidemiology
  • Sexual Dysfunction, Physiological / physiopathology

Substances

  • Adrenal Cortex Hormones
  • Dermatologic Agents
  • Itraconazole
  • Finasteride
  • Cyclosporine