INFERTILITY AND MENTAL HEALTH: CHALLENGES, MANAGEMENT AND FUTURE AHEAD

2021 ◽  
pp. 74-75
Author(s):  
Vijay Laxmi Sharma ◽  
Mini Sharma ◽  
Yashika Singh

Infertility is known to distress humanity since time is known. It does not merely affect the female or her spouse rather impacts signicantly the family as a whole. Its suffering is very stressful and even leads to a morbid mental health issue of- depression, anxiety, aggression, phobia, sexual dysfunction, dissociation and sleep disturbances. The medical management of these issues further complicates the picture with drug-related sexual side effects. Also, there is a signicant psychological and social dysfunction associated with infertility. Thus, Infertility is a multifactorial disease that needs comprehensive multidisciplinary management and care.

2021 ◽  
pp. 145507252098596
Author(s):  
Sinikka L. Kvamme ◽  
Michael M. Pedersen ◽  
Sagi Alagem-Iversen ◽  
Birgitte Thylstrup

Background: In Denmark the boundaries between cannabis as an illicit drug and licit medicine have shifted rapidly in recent years, affecting also policy. However, the vast majority of Danes, who use cannabis as medicine (CaM) continue to rely on the unregulated market for supply. This study explores patterns of use and motives for use of CaM in Denmark. Methods: An anonymous online survey was made available to a convenience sample of users of CaM from July 14, 2018 to November 1, 2018. Participants were recruited through patient organisations, social and public media, and the illegal open cannabis market. Results: Of the final sample ( n = 3,021), a majority were women (62.6%) and the mean age was 49 years. Most had no prescription for CaM (90.9%), a majority had no or limited previous experience with recreational cannabis use (63.9%), and had used CaM for two years or less (65.0%). The most common form of intake was oil (56.8%) followed by smoke (24.0%). CBD oil (65.0%) was used more than hash, pot or skunk (36.2%). Most frequent conditions treated were chronic pain (32.0%), sleep disturbances (27.5%), stress (23.7%), osteoarthritis (22.7%), anxiety (19.6%), and depression (19.6%). Overall, users experienced CaM to be effective in managing somatic and mental health conditions and reported relatively few side-effects. CBD oil only users were more likely to be women, older, have limited recreational experience and have initiated use recently. Conclusions: A new user group has emerged in Denmark that, for the most part, use illegally sourced CaM to treat a broad range of somatic and mental health conditions, often with experienced effect and relatively low level of side-effects. The prevalent use of low-potency CBD oil indicates an interest in effects beyond the high normally associated with cannabis use. More clinical research into the effects and side-effects of CaM is needed to draw the boundaries of the medical utility of cannabis.


2014 ◽  
pp. 97-98
Author(s):  
David L Brody

This chapter addresses issues surrounding sexual dysfunction after concussion. Ask the patient specifically about sexual dysfunction in private, and if appropriate ask the collateral source separately. Assess for depression, severe fatigue or hypersomnia, untreated pain, and alcohol or drug abuse (especially marijuana). Check medications for sexual side effects; serotonin specific reuptake inhibitors are the most common culprits. Test for hormonal imbalances and unrecognized cauda equina or lower spinal cord injury. Consider a trial of a PDE5 inhibitor and refer to urology for more advanced options.


2016 ◽  
Vol 33 (S1) ◽  
pp. S591-S591
Author(s):  
O.W. Muquebil Ali Al Shaban Rodriguez ◽  
S. Ocio León ◽  
M. Gómez Simón ◽  
M.J. Hernández González ◽  
E. Álvarez de Morales Gómez-Moreno ◽  
...  

IntroductionThe side effects of the various antidepressant drugs on the sexual field (with very few exceptions) are well known, and they affect the quality of life in important manners. The incidence rate, communicated spontaneously by the patient, has been estimated around 10–15%, and can reach amounts of 50–60% with SSRIs when studied specifically. It has been suggested that these effects compromise treatment adherence.ObjectivesTo estimate the incidence and intensity of the side effects on the sexual field with different antidepressants, as well as its relationship with treatment adherence.MethodologyTransversal study on 50 patients assisted in medical consultation. Collection of data in office (October 2014–October 2015).Administration of survey PRSexDQ-SALSEX. In order to research the relationship with treatment adherence, one question surveyed the patient whether he/she had thought about finishing treatment for this reason.ResultsTwenty-nine patients (58% of the sample) presented some degree of sexual dysfunction. Five individuals (17.2%) communicated it spontaneously. Nine individuals (31%) responded that they did not accept positively the changes in their sexual field, and they had thought about withdrawing treatment for this reason. They were given the test of self-compliance statement (Haynes-Sackett), with a result of four non-compliant (44.4%). The most frequently involved drugs were fluoxetine (n = 5, 10% of the sample total) and paroxetine (n = 4, 8%).ConclusionsThe high impact of sexual side effects with a low rate of spontaneous communication coincides with previous existent studies.Limitation when estimating adhesion due to methodological difficulties in the design of the study. However, high impression by using the selected method of determination.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. S545-S545 ◽  
Author(s):  
L. Gallardo Borge ◽  
C. Noval Canga ◽  
L. Rodíguez Andrés ◽  
I. Sevillano Benito ◽  
M. Hernández García ◽  
...  

IntroductionBupropion is a dual antidepressant, a norepinephrine and dopamine reuptake inhibitor. Its main use is in affective disorders as major depression. Antidepressants have been commonly associated with sexual side effects in the libido, sexual arousal, orgasm and erectile function. Bupropion has negative influence in sexual function, even it could increase the libido. Due to this, it could be a good option in patients with active sexual life and affective disorder.Clinical reportA 58-year-old female with a long history of depression disorder for 5 years. History of lots of side effects with different treatments, sexual dysfunction with serotonin-antidepressants. Treated with bupropion SR 150 mg/day and alprazolam, she suffered a relapse. The bupropion was increased to 300 mg/day. Three days later she appeared in the consultation room, presented a sense of pre-orgasmic of 72 hours of evolution, high increased libido, tiredness, muscle tension and insomnia. This sense did not improve after the sexual act. It had never happened previously. The side effect improved when the bupropion was reduced to 150 mg/day and disappeared with its withdrawal.ConclusionsThe case made a relationship between the increased of bupropion's dose and the appearance of unusual sexual side effects (increased of libido and pre-orgasmic sense). Not only bupropion is one of the antidepressants that do not cause sexual dysfunction, if not it was reported in some trials that could be a treatment against this dysfunction due to its prosexual effects. The mechanism is unknown but could be related with norepinephrine or dopamine transmission.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2019 ◽  
pp. 143-145
Author(s):  
David L. Brody

In private, ask specifically about sexual dysfunction, and if appropriate, ask the collateral source separately. Assess for depression, severe fatigue or hypersomnia, untreated pain, and alcohol or drug abuse (especially marijuana). Check medications for sexual side effects; serotonin specific reuptake inhibitors are the most common culprits. Test for hormonal imbalances and unrecognized cauda equina or lower spinal cord injury. Consider a trial of a phosphodiesterase type 5 (PDE5) inhibitor, and refer to urology for more advanced options.


2017 ◽  
Vol 41 (S1) ◽  
pp. S283-S284
Author(s):  
H. Ben Ammar ◽  
G. Hamdi ◽  
H. Zalila ◽  
Z. El Hechmi

IntroductionFor a long time, antidepressants sexual side effects have been neglected. Currently, no reliable scientific data is available regarding the nature and frequency of sexual dysfunction induced by antidepressants. The aim of our study was to evaluate the prevalence and type of sexual dysfunction induced by antidepressants, and to identify factors associated with the occurrence of these disorders.MethodologyA descriptive and analytical cross-sectional study extending over a period of two week. For the purpose of this research, a socio-demographic card, the Arizona Sexual Experiences Scale (ASEX) and the Psychotropic-Related Sexual Dysfunction Questionnaire (SALSEX) were used.ResultsFifty-five patients were recruited. The diagnosis of major depressive episodes was dominant (49.1%). Moreover, fluoxetine and tricyclic were in top of the list of antidepressants with respective proportions of 41.8% and 38.2% and respective dose 20.86 mg/24 h and 72.38 mg/24 h. The score using the ASEX scale was 14.63 ± 5.23. Using the SALSEX scale, 47.3% of patients claimed to have had sexual disorders secondary to antidepressants with a moderate score of 9.19 ± 2.56. Furthermore, sexual disorders were more common in the elderly aged of 45 (66.66%) as well as in patients started on paroxetine (66.66%) and on sertraline (66.66%) (P ≤ 0.05).ConclusionThe sexual side effects of antidepressants have a major impact on the quality of life and adherence to treatment. They also represent an important risk factor for relapse and recurrence in major depression, in this context, the prescription of an antidepressant.Disclosure of interestThe authors have not supplied their declaration of competing interest.


1995 ◽  
Vol 25 (3) ◽  
pp. 239-248 ◽  
Author(s):  
Winston W. Shen ◽  
Jeffrey H. Hsu

Objective: After the advent of selective serotonin reuptake inhibitors on the U.S. market in 1988, American psychiatrists have been faced with more choices of antidepressants for the treatment of depression. The prescribing of SSRIs has been increasing in popularity because they are easily titrated by the physicians and tolerated by patients. However, the SSRI use is frequently associated with female sexual dysfunction. The aim of this study was to describe these SSRI-associated female sexual side effects. Methods: In a retrospective series, clinic records of 110 female SSRI-treated outpatients were reviewed for loss of or decreased libido, orgasmic disturbances (anorgasmia or delayed orgasm), as well as clinical management patterns to alleviate sexual side effects. Results: Twenty-one fluoxetine-, nine paroxetine-, and five sertraline-treated cases with female sexual inhibition were identified. The fates of SSRI-associated sexual adverse effects and clinical managements of restoring these side effects were described. Conclusions: With some limitations in interpreting the data, the findings of this study suggest that SSRI-associated female sexual dysfunction occurs at a higher rate than we previously thought, equal potentials in implicating female sexual side effects among three SSRIs, and the absence or the low incidence of female sexual adverse effects from bupropion, and that these side effects can be managed by waiting for a spontaneous remission, dosage reduction of SSRIs, substitution with bupropion and other antidepressants, or the use of an antidote.


2016 ◽  
Vol 6 (4) ◽  
pp. 191-196 ◽  
Author(s):  
Elizabeth Jing ◽  
Kristyn Straw-Wilson

Abstract Sexual dysfunction is an underdiscussed adverse effect to selective serotonin reuptake inhibitors (SSRIs) and may increase the risk for discontinuation and nonadherence to antidepressant pharmacotherapy. Given the prevalence of depression, health care providers should educate patients about SSRI-associated sexual dysfunction in order to promote patient awareness and medication adherence. This study evaluated primary literature from 1997 to 2015 to identify SSRI-related sexual side effects, therapeutic alternatives, and treatment strategies. The results indicate that paroxetine is associated with the greatest rate of sexual dysfunction among the SSRIs. Potential alternatives to SSRI treatment include bupropion, mirtazapine, vilazodone, vortioxetine, and serotonin-norepinephrine reuptake inhibitors. In the event that a subject responds solely to SSRIs but experiences unwanted sexual side effects, bupropion may be added as an adjunctive medication. Some limited evidence also suggests that saffron may reduce some aspects of sexual dysfunction, excluding ability to reach orgasm.


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