Sexual dysfunction in obsessive compulsive disorder

Some evidence from community and clinical research showed that obsessive compulsive symptoms and OCD diagnosis are associated with worse sexual functioning, a higher prevalence of sexual dysfunctions and lower sexual satisfaction. In a national epidemiological study, obsessive compulsive behaviours were one of the strongest predictors of female sexual dysfunction [24]. Kendurkar and Kaur [35] showed that sexual dysfunction was more prevalent among patients with OCD (50%) in comparison with healthy controls (30%).

There are several reasons why patients with OCD may have impaired sexual functioning or satisfaction. A first one may be related to the effects of psychiatric medications [36]. Selective Serotonin Reuptake Inhibitors (SSRIs) may especially delay ejaculation and female orgasm, but also can cause decreased libido and erectile difficulties [3738]. Although SSRI-induced sexual side-effects are dose-dependent and generally reversible, high dosages are used in OCD treatment and sexual side-effects can sometimes persist after treatment discontinuation [38]. According to Balon [39], the incidence of SSRI-associated sexual dysfunction is between 30 and 50%. Another clinical aspect which may explain a worse sexual well-being in patients with OCD concerns the content of some symptoms including obsessions related to contamination with diseases, sexual/religious/moral themes, and the possibility of causing harm [40]. Other variables which may contribute to an impaired sexual life may be a poorer physical health [41] or unhealthy behaviours [42].