Do my long-term psychiatric meds lead to sexual dysfunction?

Question

Hello doctor,

I underwent DNS surgery twice, after which my doctor referred me to Psychiatry. There, I was treated with intravenous haloperidol, which caused significant restlessness. As a result, my medication was changed to fluoxetine and olanzapine, which I have been taking for the past 2.5 years. Since then, I have experienced reduced sexual arousal, a decrease in penile size (previously 6–6.5 inches, now approximately 5–5.5 inches), reduced erectile firmness, and shorter duration of sexual intercourse.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your worries, and your symptoms make sense based on your medical background and the medicines you are currently taking.

Both Fluoxetine and Olanzapine are known to lower a person's libido, make them less aroused, weaken or delay erections, and make it harder to perform sexual acts, especially after long-term use. The fact that these effects do not mean permanent damage is a good thing.

It is more likely that the feeling of a smaller penile is caused by a worsening erection and less blood flow than by a real loss of penile tissue. As sexual function gets better, size usually goes back to how it was before. Reviewing the drug schedule and making changes like lowering the dose, switching to more sexually acceptable medications, or adding supportive treatment while under the supervision of a psychiatrist can make a big difference in libido and erectile dysfunction.

Lifestyle changes like controlling weight, getting enough sleep, being physically active regularly, and lowering stress also play a big role in healing. Do not stop taking any drugs or change the way they are taken without first talking to your psychiatrist. Changes should be made slowly and safely.

Have you gained weight or felt tired since you started taking these medicines?

I hope this answers your questions.

We appreciate your comments and use them to make patient care better.

Thanks.