Peripheral neuropathy is often associated with a loss of feeling, muscle weakness, or numbing sensation in the extremities, primarily in the hands and feet. Since this type of neuropathy is associated with the peripheral nervous system, it can also be associated with disrupting normal processes in other parts of the body, including the genital areas of both men and women. Sexual dysfunction is not exclusively associated with any one disorder or condition, so there could be many reasons for losing sexual function. Keep reading to find out how peripheral neuropathy is associated with sexual dysfunction.
Can Peripheral Neuropathy Cause Sexual Dysfunction?
The causes of sexual dysfunction are not always understood. While the reasons could be numerous, it’s important to look at how the body normally functions regarding the mechanics of intercourse to understand how this function can be impaired.
Yes, peripheral neuropathy can cause sexual dysfunction, particularly any of a number of sexual sensory disorders. The pudendal nerve is the primary nerve in your pelvic region and is responsible for supplying sensation and motor information from the genital area. This nerve is a part of the peripheral nervous system, which means it can be disrupted by peripheral neuropathy.
Sexual dysfunction is not uncommon, and for many, it is a normal part of aging. If you are experiencing it without the presence of any other health problems, speak to your physician about the possibility of underlying polyneuropathy.
Types of Sexual Dysfunction Associated with Peripheral Neuropathy
It’s important to know the various types of sexual dysfunction that can occur with peripheral neuropathy. Remember to always consult with your physician about symptoms you’re experiencing and avoid self-diagnosis.
If you are experiencing impaired neural control in your genital area, you may experience any of the following responses:
- Erectile dysfunction
- Loss of genital sensitivity
- Ejaculation disorder
- Loss of vaginal lubrication
- Orgasmic disorder
- Loss of sexual desire
Some of these types of sexual dysfunction double as symptoms to mention to your physician when determining if peripheral neuropathy is the cause. Let’s take a deeper look at what other symptoms you might experience.
Symptoms of Sexual Dysfunction Associated with Peripheral Neuropathy
Although this condition can occur in men and women, the types of sexual dysfunction will differ as well as the treatments. For example, the loss of lubrication is a symptom only experienced by women, whereas only men experience erectile dysfunction.
The following is a list of symptoms you could experience with sexual dysfunction:
- Loss of lubrication
- Loss of erotic sensation
- Loss of feeling during intercourse
- Ejaculatory disturbances (premature, delayed, absent, dribbling)
- Erectile dysfunction (attain, sustain)
- Difficulties in reaching orgasm
- Changes in the sensation of orgasm
- Pain during intercourse
Erectile dysfunction is common in many men, particularly as men age. Current treatments for erectile dysfunction include PDE5 inhibitors such as Viagra™ and Cialis™. However, these drugs do little for sexual sensory problems, and nothing for women. Erectile dysfunction differs from sexual sensory disorders.
The penis and the vulva are highly sensitive organs in men and women, respectively, that contain thousands of nerve endings. In order for sexual arousal to occur, these nerve endings need to be stimulated properly. When a disruption of sensation occurs, it can be more difficult for men and women to become aroused, reach orgasm or ejaculation and enjoy sexual activity. This disruption can be a change to an individual that is sudden/acute, as in disease or injury, or gradual/chronic, as observed with aging. This disruption can lead to loss of sensitivity/hyposensitivity, hypersensitivity or pain, or other sensory problems or disorders, all of which can lead to an inability to enter relationships, cause strain in relationships, reduce a partner’s sexual satisfaction and cause psychological damage to sufferers.
Remember, these symptoms alone do not automatically indicate sexual dysfunction or peripheral neuropathy, so consult your physician for a diagnosis.
Treatment of Sexual Dysfunction Associated with Peripheral Neuropathy
For the treatment of sexual dysfunction associated with peripheral neuropathy, there are different lines of therapy. Besides your regular course of peripheral neuropathy treatment, your physician may recommend one or more of the following treatments:
- Phosphodiesterase type 5 (PDE5) inhibitors
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Intracavernosal njiections (ICI)
- Vacuum erection devices (VED)
- Penile implant surgery
SSRIs and Sexual Dysfunction
While PDE5 inhibitors are the first-line treatment in sexual dysfunction, particularly as it pertains to erectile dysfunction, some approaches use a combination of PDE5 inhibitors and SSRIs. However, SSRIs have been shown to cause a reduced interest in sex, difficulty in arousal, sustained arousal and reaching orgasm, among other symptoms.
What are Selective Serotonin Reuptake Inhibitors?
Selective serotonin reuptake inhibitors (SSRIs) are antidepressants. SSRIs increase levels of serotonin, a neurotransmitter that carries signals between neurons. SSRIs are combined with PDE5 inhibitors to treat one aspect of sexual dysfunction, premature ejaculation.
Common SSRI medications include the following:
- Fluoxetine (Prozac)
- Fluvoxamine (Luvox)
- Citalopram (Celexa)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Escitalopram (Lexapro)
- Vortioxetine (Trintellix, formerly Brintellix)
SSRIs and Sensory Changes
In addition to the sexual dysfunction symptoms mentioned, including not being able to have an orgasm at all, most SSRIs have been linked to genital sensory changes. Nearly 100% of SSRI users have attested to experiencing genital sensory changes of some degree thirty minutes after taking the medication. The sensory changes include reduced sensitivity, often described as a “numbing” sensation or genital arousal (irritability).
While reduced sensitivity causes a delay in ejaculation, the intended result of being combined with PDE5 inhibitors to treat premature ejaculation, they also cause a dulling of orgasm in both sexes and an eventual total loss of orgasm with continued use.
Though many of the side effects cease when the medication is stopped, there have been conditions, such as post-SSRI sexual dysfunction (PSSD) and persistent genital disorder (PGAD), that are linked to the discontinuation of SSRI medications.
If you are experiencing sexual dysfunction symptoms while taking SSRIs, your doctor may recommend combining your medication with other drugs like Sildenafil (Viagra). However, Viagra has one function, and while it may help to achieve an erection, it can not assist with loss of sensation, reduction in intensity, or total loss of orgasm.
Much is still being learned about the association between peripheral neuropathy and sexual dysfunction, and new treatments and therapies are being actively researched. Continue to speak with your doctor about symptoms you experience, so the best course of action can be determined.
On the horizon for 2023 is a double-blind trial for the treatment of reduced penile sensation and/or orgasmic dysfunction. Subscribe to our email newsletter and stay tuned for more information.
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- “Peripheral Neuropathy: What It Is, Symptoms & Treatment”. Cleveland Clinic
- “Sexual dysfunction in patients with peripheral nervous system lesions – PubMed”. National Library of Medicine
- “Sexual Dysfunction in Patients with Peripheral Nervous System Disorders”. Autonomic Neuroscience
- “Neuroprotective and Nerve Regenerative Approaches for Treatment of Erectile Dysfunction after Cavernous Nerve Injury”. MDPI
- “When an SSRI medication impacts your sex life – Harvard Health”. Harvard Health Publishing
- “Selective serotonin reuptake inhibitors (SSRIs) – Mayo Clinic”. Mayo Clinic
- “Post-SSRI sexual dysfunction & other enduring sexual dysfunctions – PMC”. National Library of Medicine