Gender specific sexual dysfunction in patients with depression

Abstract

BackgroundThis study aims to investigate the factors associated with sexual dysfunction (SD), with a particular focus on the influence of sex on the occurrence and severity of this condition in patients with major depressive disorder (MDD).MethodSociodemographic and clinical assessments were conducted on 273 patients with MDD (female = 174, male = 99), including the ASEX, QIDS-SR16, GAD-7, and PHQ-15. Univariate analyses, independent samples t-test, Chi-square test, and Fisher’s exact test were used as appropriate, and logistic regression analysis was used to identify correlation factors for SD. Statistical analyses were performed using the Statistical Analysis System (SAS 9.4).ResultSD was reported in 61.9% of the participants (ASEX score = 19.6 ± 5.5), and the prevalence of it in females (75.3%, ASEX score = 21.1 ± 5.4) was significantly higher than that in males (38.4%, ASEX score = 17.1 ± 4.6). Factors associated with SD included being female, being aged 45 years or above, having a low monthly income (≤750 USD), feeling more sluggish than usual (a QIDS-SR16 Item 15 score of 1 or above), and having somatic symptoms (evaluated with the total score of PHQ15).LimitationThe use of antidepressants and antipsychotics might be a confounding factor affecting sexual function. Also, the lack of information in the clinical data regarding the number, duration, and time of onset of the episodes limits the richness of the results.ConclusionOur findings reveal the sex differences in the prevalence and severity of SD in patients with MDD. Evaluated with the ASEX score, female patients showed significantly worse sexual function than male patients. Being female, having a low monthly income, being aged 45 years or above, feeling sluggish, and having somatic symptoms may increase the risk of SD in patients with MDD.

Sexual Dysfunction Induced by Antidepressants—A Pharmacovigilance Study Using Data from VigiBaseTM

“…In view of the current literature, both male and female patients appear to be strongly affected by sexual dysfunction under antidepressants. The low rate of reports of affected women is particularly surprising in light of the fact that sexual dysfunction, as a symptom of a depressive disorder, appears to have an even higher prevalence in women [8]. It is therefore recommended that increased reporting of behavior and regular queries about adverse ADRs in daily clinical practice be encouraged.…”

“…Despite that low sexual desire and functioning has been reported in 25 to 75% of patients with MDD who are not taking medication [8,9], numerous studies reported a prevalence of sexual dysfunction across different ADs, ranging from 4 up to 80% [10][11][12]. Since SSRIs/SNRIs are one of the most prescribed ADs, it is not surprising that several studies report an incidence of sexual dysfunction ranging from 58 to 73% during treatment with these medications [13].…”

Effect of l-arginine compared to placebo on sexual function in women with major depressive disorder: a randomized controlled trial

“…The prevalence of sexual disorders in the patients with major depressive disorder has been reported differently. In some studies, this disorder was reported in nearly half of patients with major depressive disorder [ 12 , 13 ]. A meta-analysis in 2022 showed that sexual dysfunction is prevalent in females with depressive disorders who are not in the pharmacological treatment.…”

Using network analysis to model associations between psychological symptoms, sexual function, and sexual distress in women

“…Psychological difficulties (e.g., depression, anxiety, and somatization), are some of the most important risk factors for women's sexual dysfunction ( Gonçalves et al, 2023 ; Moyneur et al, 2020 ; Polland et al, 2019 ). Associations between depressive, anxious, and somatic symptoms and problems with domains of sexual function are particularly notable in women (e.g., Gonçalves et al, 2023 ; Herder et al, 2023 ; Liu et al, 2023) . Women exhibit higher rates of sexual impairment across domains, as well as higher rates of comorbidity between psychological symptomatology and sexual function problems than men (for meta-analyses and reviews, see Briken et al, 2020 ; Gonçalves et al, 2023 ).…”