273 Nursing Care of the Postmenopausal Woman, 3rd Edition
Chronic conditions that affect sexual response As women age, the likelihood of devel- oping chronic diseases increases. Chronic conditions such as hypertension, diabe- tes, and neurological diseases can phys- iologically affect the woman’s ability to become aroused because of decreased blood flow to the genital area. This sit - uation can cause suboptimal vaginal en- gorgement during orgasm. Women with diseases such as osteoarthritis or rheuma- toid arthritis may have difficulty moving, which can result in physical pain when try- ing to do movements necessary for sexual intercourse (Kingsberg & Faubion, 2019). Many medications that a woman may take as she ages can cause difficulties with sexual function (see Table 1-2). As a woman ages, her kidneys and liver may lose some of their normal functioning. Most medications are metabolized and excreted through the liver or kidneys. If a woman has any decrease in the function of these two organ systems, this condi- tion can result in a decreased clearance and enhanced toxicity of many drugs. As women age, they may be prescribed anti- depressants. Selective serotonin reuptake inhibitors are one of the most frequently prescribed medications for depression, and they are associated with decreased desire. When possible, the woman should be switched to a different medication (Kingsberg & Faubion, 2019).
Table 1-2. Medications Associated with Sexual Dysfunction Antidepressants ● Selective serotonin reuptake inhibitors. ● Monoamine oxidase inhibitors. ● Benzodiazepines. ● Tricyclic antidepressants. ● Lithium. ● Antipsychotics. ● Barbiturates. ● Trazodone. ● Venlafaxine. Cardiovascular Medications ● Beta-blockers. ● Lipid-lowering medications. ● Digoxin. ● Clonidine. ● Spironolactone. ● Methyldopa. Other Medications ● Gonadotropin-releasing hormone agonists. ● Antiandrogens. ● Oral contraceptives. ● Neuroleptics. ● Steroids.
● Antiepileptics. ● Antihistamines. ● Anticholinergics. ● Indomethacin. ● Ketoconazole. ● Narcotics.
Note. Adapted from: Valeiro, C., Matos, C., Scholl, J., & van Hunsel, F. (2022). Drug-induced sexual dysfunction: An analysis of reports to a national pharmacovigilance data- base. Drug Safety, 45 (6), 639-650.
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