Shhh! Sex is a taboo topic. Even though advertising, TV and tabloids are filled with suggestive images, people have a hard time talking about their own personal problems.

Jim is reluctant to ask his doctor about a delicate matter. He writes, “I have trouble achieving a satisfying orgasm, if any at all.” He wonders if his blood pressure medicine (verapamil and hydrochlorothiazide plus triamterene abbreviated as HCTZ & TMT) might be responsible.

Bill too is afraid to discuss his difficulty. He confides “Try as I might, I have a hard time maintaining an erection. This makes marital relations almost impossible. I know I am not satisfying my wife sexually and it makes me very frustrated.” Bill takes a medicine for depression and eye drops for glaucoma. Although these drugs could be contributing to the problem, Bill’s doctor never mentioned a word about sexual side effects.

Men aren’t the only ones to experience changes in sexuality. Women may not realize that a loss in libido can be brought on by medicine. There is very little research on how drugs affect female sex drive, but many common prescriptions may interfere with this basic human behavior.

Women are often timid about asking a male physician or pharmacist about such sensitive topics. Perhaps even more troublesome is the issue of sexual fulfillment. Jo Ann wrote to tell us that her antidepressant, fluoxetine (Prozac), had robbed her of the ability to achieve orgasm. “My husband tries to please me in every way he can, but I just can’t seem to get over the edge any more. It leaves him exhausted and me disappointed.”

If you would like to know more about this complex issue you may wish to review our free Guide to Drugs That Affect Sexuality. We list common medicines that have sexual side effects and treatments for impotence. You can also download for free our Guide to Female Sexuality.

Physicians often worry that mentioning such a side effect will set their patients up to experience psychosomatic trouble. But lack of information can be equally devastating. If a person doesn’t realize the medication is to blame, one or both partners may become depressed and marital problems could ensue.

Of course, not all sexual difficulties can be attributed to drugs. Hormones, attitudes and romance can all make a difference. One reader believes there is too much emphasis placed on sexuality in later years: “Why can’t a loss of sex drive be considered a natural part of life, like graying hair, arthritis and aging of organs? Honeymoons can’t possibly last forever, just as an appetite for rich desserts eventually disappears.

“Men and women are different, physically and emotionally. Wives shouldn’t feel abnormal if, after years of happy marriage, they lose interest in romancing like teenagers. Let’s recognize the reality of aging and its normal effects on female sex interest.”

Not everyone agrees that sexuality should fade with the years. Many couples report a satisfying relationship even beyond their fiftieth anniversary.

In this most intimate part of life people should not have to conform to societal expectations, but rather to discover what is right for them. Medicines should not be allowed to throw a monkey wrench into this delicate balance.

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  1. RMD

    I have to respectfully take exception to the cavalier statement “I cannot resist noting how much of “Art, Literature, Music, Puppies, Flowers, Kittens, the intimacy of walking along the beach holding hands” is caused and controlled by sex.” I totally disagree with the suggested argument that our genetic history dictates our mental and physical approach to pleasurable experiences including sex.
    This is a total cop out that assumes we have no free will and that we are all slaves to our genes. It is also a popular mis-interpretation of Fruedian psychology, that is outdated and just plain incorrect. While Van Gogh painted his masterpiece’s these is little or no evidence to substantiate that his paintings were “caused and controlled” by his sexual desires.
    I played piano for 15 years, grew orchids, and went to concerts for most of my life and I never felt a sexual twinge any of the times I was enjoying these pursuits. It is sad that we still hold with the misguided simplistic theory that continuing the genome or propagation of the species is the primal pleasure in life to the exclusion of all others; and that we are “driven” mindlessly, uncontrollably and unalterably toward it. One would think that human beings have advanced beyond that and I believe there is abundant evidence to suggest that is true in developed as well as developing societies.

  2. DWD

    I cannot resist noting how much of “Art, Literature, Music, Puppies, Flowers, Kittens, the intimacy of walking along the beach holding hands” is caused and controlled by sex. We are driven by our genome to continue the genome, and sex is the mechanism. Once we are fed, clothed, and sheltered the next need to be satisfied quite likely is procreation.
    Aphrodisiacs have been around about as long as mankind, but modern medicine and modern advertising have made it really big business.
    I like the Prairie Home Companion joke where the lady buys 10,000 aspirin, tints them blue and sells them on the internet as viagra.

  3. RMD

    I find it amazing that Sex or the lack of it takes up so much of peoples lives. We either get too much, not enough or none at all. Like teenagers, we are proud of our sexual prowess and our ability to “satisfy” the opposite sex. We giggle like little kids at the titillation of sexual talk and sexual jokes, while complaining about overpopulation in “the rest of the world”. We consider ourselves failures if we are not sexual.
    What ever happened to Art, Literature, Music, Puppies, Flowers, Kittens, the intimacy of walking along the beach holding hands, sitting on a bench watching the sun set below the sea and the millions of other things which bring us pleasure. When did an erection or the lack of one become the defining moment in a person’s life.
    We may have advanced enormously from our cave man ancestors in most things, but not sexually. It is sad that so many educated and informed people see themselves as failures if they can’t “perform” sexually. My suggestion is to try not wanting sex so badly and not dwelling on it and you may be surprised at the results.

  4. bill w

    Even one instance of a ‘failed’ erection can lead to impotence. For months or even years. Men panic and are ashamed as if their very manhood depends on an erection every time. “It’s all in your head” is correct but not helpful. The fear caused by the ‘failure’ can inhibit sexual arousal and the only cure I know of is an understanding woman.
    A man’s expectation that he can ‘perform’ every time is a young man’s idea. What he doesn’t know is that a man’s arousal runs in cycles of 90 minutes. So if nothing is happening, try again later. Age is obviously also a factor.
    Speaking from personal experience and from teaching sex in college for decades.

  5. DWD

    I know from personal experience that drugs can cause problems (I gave up Paxil for Meditation). I would remind folks that the most powerful sexual organ is between your ears, so use it. Here are 7 suggestions for a highly effective love life.
    1. Erections are not necessary for orgasm.
    2. Penetration is not necessary for orgasm.
    3. If at first you don’t succeed, try again another day, or even later in that day.
    4. Foreplay does not have to lead to sex and even orgasms are not mandatory, it is the journey not the destination that is important.
    5. Some wives consider doing the dishes or housework by the husband to be great foreplay.
    6. Have some no orgasm allowed heavy petting and necking sessions.
    7. Make sure to keep lubricants and tissues nearby.
    BTW retirement has helped us. Caressing and foreplay before breakfast, a hearty breakfast, a morning’s yard work or shopping, and more serious love making in the afternoon.

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