Ejaculatory dysfunction

MDD. Adverse reactions occurring in at least 3% of patients include the following abnormal orgasm, anxiety, blurred vision, constipation, decreased appetite/anorexia, decreased libido, delayed ejaculation, diarrhea, dizziness, dry mouth, ejaculatory dysfunction, erectile dysfunction, fatigue, increased sweating, insomnia, nausea, somnolence, tremor, vomiting. 

Of particular importance in the geriatric patient Orthostatic hypotension, worsening of urge or mixed urinary incontinence, ejaculatory dysfunction... 

Sexual Anorgasmia, ejaculatory dysfunction, impotence, priapism, reduced libido Dopamine 2 Consider sexual dysfunction if poor compliance... 

The relation of prolactin concentrations and certain adverse events has been explored in large randomized, double-blind studies. In 813 women and 1912 men, haloperidol produced dose-related increases in plasma prolactin concentrations in men and women, but they were not correlated with adverse events such as amenorrhea, galactorrhea, or reduced libido in women or with erectile dysfunction, ejaculatory dysfunction, gynecomastia, or reduced libido in men (470). 

Prior to the use of wakefulness-promoting agents, and in some pediatric patients, maintenance of wakefulness is dependent on stimulant medications and antidepressants. The safety of such medications during reproductive years and the risk of driving accidents without medication are typically handled during discussions between the prescribing practitioner and the patient. Irritability, anxiety, and erectile or ejaculatory dysfunction have been reported with these medications (78). The costs of newly approved medications for the treatment of narcolepsy,... 

Blanker MH, Bosch JL, Groeneveld FP et al. Erectile and ejaculatory dysfunction in a community-based sample of men 50-78 years old prevalence, concerns and relation to sexual activity, Urology 2001 57 763-768,... 

Blanker MH, Bohnen AM, Groeneveld FP et al, Correlates for erectile and ejaculatory dysfunction in older Dutch men a community-based study, J Am Geriatr Soc 2001 49 436-442,... 

Neuroleptic drug-induced sexual dysfunction, including erectile and ejaculatory dysfunction and changes in libido and the quality of orgasm, appear to be reversible on withdrawal. 

The frequency and course of sexual disturbances associated with clozapine have been studied in a prospective open study in 75 men and 25 women, mean age 29 years, and compared with the effects of haloperidol in 41 men and 12 women, mean age 26 years (200). There were no statistically significant differences between the patients taking haloperidol and those taking clozapine. During 1-6 weeks of treatment with clozapine, the most frequent sexual disturbances among women were diminished sexual desire (28%) and amenorrhea (12%), while among men they were diminished sexual desire (57%), erectile dysfunction (24%), orgasmic dysfunction (23%), ejaculatory dysfunction (21%), and increased sexual desire (15%). The mean daily doses were haloperidol 16 mg and clozapine 261 mg. 

Ejaculatory dysfunction has also been associated with risperidone in three cases. 

Kaneda Y. Risperidone-induced ejaculatory dysfunction a case report. Eur Psychiatry 2001 16(2) 134—5. 

Sexual dysfunction (men decreased libido, erectile disturbance, impotence, ejaculatory dysfunction, abnormal orgasm women decreased libido, abnormal orgasm)... 

Sexual function in men can be compromised by cisplatin + vinblastine + bleomycin chemotherapy. Of 54 patients, 29 had disorders of sexual function 2 years after completion of treatment (234). Ejaculatory dysfunction was tentatively linked to chemotherapy in 30% of those affected. There was reduced libido, usually reversible, in 40 at the time of chemotherapy. 

Spermatogenesis 187 Ejaculatory dysfunction 188 Reproductive tract/performance 189... 

Stallions may have problems with penile erection secondary to traumatic injury of the penis. In other stallions, ejaculatory dysfunction, secondary to neurological and musculoskeletal problems that affect the stallion s ability to mount and thrust, may be the primary cause of breeding failure. In these cases, ejaculation in copula or ex copula may be enhanced pharmacologically. 

Tiredness and asthenia, ejaculatory dysfunction, flu-hke symptoms, and nasal congestion are the most common adverse effects of tamsulosin. These adverse effects are unavoidable, but by properly educating the patient, they should not lead to discontinuation of treatment. 

Sexual function In a post hoc analysis of a Japanese trial, ejaculatory dysfunction was associated with larger symptomatic improvements in lower urinary tract symptoms with silodosin [95. The authors suggested that the pharmacological receptor target for improvement in the symptoms of benign prostatic hyperplasia may be the same target as that for ejaculatory dysfunction. 

Sexual function There was a clear association between a-adrenoceptor antagonists and ejaculatory dysfunction (pain/discom-fort) in an observational study in Spanish men with benign prostatic hyperplasia and/or lower urinary tract symptoms [106 ]. The presence and severity of symptoms were assessed using the male sexual health questionnaire there was an 83% prevalence of ejaculatory dysfunction in patients taking a-adrenoceptor antagonists. Most cases of ejaculatory dysfunction were mild and severe dysfunction occurred in only 4% of cases. Although the adverse effects on sexual function were seen with all of the a-adrenoceptor antagonists, alfuzosin was associated with better ejaculatory function than tamsulosin, terazosin, or doxazosin. 

Sexual function While ejaculatory disorders have been attributed to a-adrenoceptor antagonists it is less clear whether they affect semen. In a randomized, doubleblind, placebo-controlled 3-way crossover study of sperm in 48 healthy men after exposure to tamsulosin, alfuzosin, and placebo for 5 days each tamsulosin was associated with negative effects on ejaculate volume, sperm concentration, total sperm count, semen viscosity, and sperm motility compared with placebo alfuzosin was comparable to placebo [115 ]. Post-ejaculate urine sperm concentrations were comparatively normal between all agents, suggesting that retrograde ejaculation is not responsible for the ejaculatory dysfunction. There was complete absence of ejaculation in 17 of the 48 men (35%) during treatment with tamsulosin compared with none in the other groups. 

---