Depression and sexual dysfunction

For sexual medicine the relationship between depression and sexual functioning is of major importance since both affective and sexual disorders are highly prevalent, are thought to exhibit a marked co-morbidity and might even share a common etiology. A high percentage of men and women suffering from mild, moderate, or severe forms of depression experiences sexual dysfunction. However, the relationship between depressive mood and sexual dysfunction is bidirectional and further complicated by the sexual side effects of antidepressant treatment, thus constituting a complex network of factors. In women, sexual desire was found to be the sexual sphere predominantly affected by depressive illness, while in male patients both sexual desire and erectile function tend to be impaired. As a consequence, sexually dysfunctional patients should be routinely screened for symptoms of depression. Since improvements in sexual functioning consistently belong to the most significant predictors of depression remission, adequate treatment of sexual functioning should be an integral component of therapy for all depressed men and women - irrespective of the causal relationship between both conditions.