Ejaculation disorder

Drug-induced sexual dysfunction Ejaculation disorders Decreased libido, erectile dysfunction, ejaculation disorders... 

Ejaculation disorders, including delayed and retrograde ejaculation, occur with all adrenergic antagonists and are an... 

If the patient is started on a 5a-reductase inhibitor, monitor the patient for drug-induced decreased libido, erectile dysfunction, or ejaculation disorders. If severe, discontinue the drug. 

Common side effects of the SSRIs are somnolence, nausea, ejaculation disorders, decreased libido, dry mouth, insomnia, and fatigue. Tricyclic antidepressants (TCAs) commonly cause sedation, orthostatic hypotension, anticholinergic effects, and weight gain. TCAs are very toxic on overdose. 

Eseitalopram Nausea, insomnia, ejaculation disorder, somnolence, increased sweating, fatigue... 

Adverse effects include activation of mania/hypomania, dizziness, insomnia, agitation, nausea and vomiting, dry mouth, diarrhoea, tachycardia, postural hypotension, cardiac failure, MI, arthralgia, myalgia, arthritis, purpura, anaemia, leukocytosis, decreased or increased weight, thirst, ejaculation disorder, impotence, dysmenor-rhoea, decreased or increased libido, coughing, epistaxis, bronchitis, rash, pruritus, photosensitivity reaction, urticaria, acne, abnormal accommodation, conjunctivitis, eye pain, fatigue and fever. 

Adverse effects include decreased libido, ejaculation disorders and erectile dysfunction. 

Treatment for at least 3-6 months is necessary to see increased hair growth or prevent further hair loss. Continued treatment with finasteride is necessary to sustain benefit. Reported adverse effects include decreased libido, ejaculation disorders, and erectile dysfunction, which resolve in most men who remain on therapy and in all men who discontinue finasteride. 

The effects of finasteride (n = 545), tamsulosin, or the proprietary herbal remedy Permixon on sexual function have been studied in patients with lower urinary tract symptoms due to benign prostatic hyperplasia (64). At 6 months tamsulosin and finasteride caused slight increases in sexual disorders and Permixon caused a slight improvement. Ejaculation disorders were the most frequently reported adverse effects after tamsulosin or finasteride. 

Their most frequent adverse events (nausea, somnolence, dry mouth, increased sweating) are mainly transient and mostly mild to moderate (3). In terms of adverse effects escitalopram appears to be equivalent to citalopram. For example, in placebo-controlled trials, escitalopram produced unwanted effects typical of the SSRI class, including nausea (15%), ejaculation disorders (9%), insomnia (9%), diarrhea (8%), somnolence (7%), dry mouth (6%), and dizziness (6%). 

Sexual function Decreased libido Impotence Ejaculation disorder Anorgasmia... 

Clinical studies have reported very few adverse effects that are of a mild nature (usually gastric distress or headache) following saw palmetto administration at normal doses. One randomized, double-blind study of finasteride, tamsulosin, and saw palmetto for 3 months observed no differences among the three treatments in terms of the effectiveness measures and no change in sexual function in those individuals receiving saw palmetto, though ejaculation disorders were noted as the most common side effect in those individuals receiving either tamsulosin or finasteride (26). 

The most common adverse events of venlafaxine in patients with GAD were nausea, somnolence, and dry mouth." Paroxetine was associated with a high rate of somnolence, nausea, abnormal ejaculation, dry mouth, decreased libido, and asthenia compared with placebo." Escitalopram caused nausea, insomnia, fatigue, decreased libido, ejaculation disorders, and decreased libido at a higher rate than placebo in patients with GAD. The use of TCAs may be limited by troublesome adverse events (e.g., sedation, orthostatic hypotension,... 

Erectile dysfunction has been reported in 3% to 5% of patients. It may be secondary to ejaculation disorders, or may be due to drug-induced inhibition of nitric oxide synthase (which is needed for producing nitric oxide, a vasodUatory substance) in cavemosal tissue. The role of 5a-reductase inhibitors in causing erectile dysfunction is not clear, as elderly men with BPH commonly develop erectile dysfunction as they age, or have concurrent medical illnesses or concomitant drug therapies that may predispose to the development of sexual dysfunction. ... 

Homma Y, Kawabe K, Takeda M, Yoshida M. Ejaculation disorder is associated with increased efficacy of silodosin for benign prostatic hyperplasia. Urology 2010 76(6) 1446-50. 

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