Sexual Pharmacology: Love Potions, Pills, and Poisons

Abstract

The human population is increasingly exposed to chemicals that affect sexual function, from industrial pollutants to life-saving pharmaceuticals. First, the products that can cause dysfunction, including endocrine disruptors, drugs of abuse, and prescription medications, are reviewed. A systemic perspective proves helpful in explaining the large variability in effects and side effects of medications. Secondly, the biological treatments of sexual dysfunction are presented in light of the age-old human wish to control desire and sexual response. It is proposed that the development of the phosphodiesterase type 5 inhibitors (PDE-5 inhibitors) constitutes a turning point in this search for control. They contribute markedly to a shift from seeing sexual dysfunctions as “problems of living” to approaching them as medical disorders. The advantages and pitfalls of this “medicalization of sex” are discussed, focusing in particular on the social roles and expectations that are inherent in the disease model. Finally, the need for a systemic approach to sexual pharmacology, involving the physiological, individual, relational, and socioeconomic levels, is emphasized. A majority of patients with sexual dysfunctions first consult their primary care physician. The tension between the need for a comprehensive, systemic approach and the physician's constraints of time and expertise represents a challenge, the resolution of which is likely to determine the future of the field of sex therapy.

KEYWORDS:

• sexual pharmacology
• chemicals that cause dysfunction
• system perspective in treatment

Notes

¹ Note that most studies were conducted on male subjects and that there is a lack of data on females. We have generalized the data to the whole population, which is a logical extension rather than being databased.

² There are some anecdotal reports that women can be helped with PDE-5 inhibitors for arousal problems and delayed orgasm, when caused by SSRI antidepressants.