Are There Any Sex/Gender Differences in Post-Selective Serotonin Reuptake Inhibitors (SSRI) Sexual Dysfunction (PSDD)?

Because of the sex/gender differences in the manifestation of depression, one can assume the possible existence of gender differences in post-SSRI sexual dysfunction (PSSD). This article tries to summarize the available data on sex/gender differences in PSSD and to evaluate if different approaches in diagnosis or treatment of different genders are needed.

Depression is a leading cause of disability worldwide. Studies observed gender differences in prevalence and clinical presentation of depression, adherence to treatment and pharmacological features of antidepressant treatment. Sexual adverse events during the use of antidepressants are well-known and occur frequently. PSSD has been recently recognized as a medical condition that can outlast discontinuation of SSRI and SNRI antidepressants. The published literature on PSDD is lacking a clear definition of PSSD and data on possible sex/gender differences are very limited. The available information shows some gender differences in frequency of the different presented symptoms, but development of validated clinical assessment instruments of all possible sexual complaints, including genital anesthesia and pleasureless orgasm, is necessary.

The available scientific literature is lacking profound information about the extent, the mechanism, and possible treatment of PSSD and sex/gender differences as well. Physicians should assess sexual function prior, during, and also after treatment with antidepressants and be aware of the possibility of PSSD. Physicians should inform their patients about the possible sexual consequences of antidepressant treatment and include it, when possible, in the treatment decision-making process.