ANORGASMIA CAUSED BY GLAUCOMA MEDICATIONSOphthalmologist Carolina Valdivia, MD discusses anorgasmia and whether it can be caused by glaucoma medications.  A 54 year-old man from New York, USA writes:Hi Dr. Valdavia, God bless you for all the great work you are doing:) I have a somewhat embarrassing question to ask. I have been treated for glaucoma for about the past year. The Travatan Z eye drops for glaucoma that I am taking work well. But I have noticed some unusual, never-before-experienced, sexual difficulties since around the time I starting using these eye drops. Specifically, I have some difficulty reaching an orgasm during intercourse. I didn't think that the reason could be the Travatan Z, but then I did read on a website that eye drops for glaucoma can cause sexual side effects like the one I mentioned. Thinking back, the bedroom abnormalities definitely started right around the time of being first treated for glaucoma. I also am taking three other medications: Lunesta, Ativan, and Prozac, but these are not for the glaucoma. Are the Travatan Z and sexual difficulties possibly related in your view? Thanks for your time and expertise!
Anorgasmia also can be situational, caused by opiate use, alcoholism, depression, grief, other psychiatric problems (including performance anxiety), and the use of certain medications. The most common medications causing anorgasmia are selective seratonin reuptake inhibitors (SSRI) used to treat depression, obsessive-compulsive disorder, and generalized anxiety disorder. The drug Prozac that you are taking is an SSRI. Estimates of medication-induced anorgasmia range from 15-50%. Some medicines that are used to control high intraocular pressure can cause sexual side effects. These medicines are beta-blockers, such as Timolol, Betaxolol, and Levobunolol. Beta-blockers also are used widely to decrease high blood pressure (hypertension). It is very common for people with hypertension to be prescribed beta-blockers. Thus, these medicines are widely used and beta blocker side effects are well known. Beta blocker side effects experienced by a minority of glaucoma patients include: decreased libido, impotence, difficulty achieving orgasm, and Peyronie's disease (abnormal curvature of the penis). These beta blocker side effects are rare. Beta blockers regularly are used alone or in combination with other eye drops for glaucoma to control high intraocular pressure.You are using Travatan Z (travoprost) eye drops for glaucoma to control your high intraocular pressure. Travatan Z has not been associated with the beta blocker side effects described above. Thus, it is unlikely that it is the cause of your anorgasmia. You also are taking three other medications – Prozac (fluoxetine), Ativan (lorazepam), and Lunesta (eszopiclone) – each of which has documented sexual side effects, including anorgasmia. Any of these medications alone, or in combination, could be responsible for the sexual side effects that you are experiencing. I recommend that you speak openly to your regular physician and your ophthalmologist about your concerns. The primary goal is to discover the cause (or causes) of your anorgasmia. Once this has been established, informed decisions can be made about how to proceed. If you remain convinced that the Travatan Z eye drops for glaucoma are a contributing factor to the problem, then it is important to ensure that you are administering the eye drops properly. Our glaucoma treatment page contains the section Guidelines for Taking Eye Drops. Following these instructions will significantly reduce the occurrence of systemic side effects from the use of eye drops for glaucoma. However, I emphasize again that it is unlikely that Travatan Z is the problem. There is some evidence that medication-induced sexual side effects diminish with time. However, it has been my experience that this information does little to assuage the anxiety that patients feel. Most want a quicker and more definitive solution. Although I understand that this is an uncomfortable situation for you, it is very important that you continue taking your medications as directed without fail. There are alternatives to Prosac, Ativan, and Lunesta that do not have reported sexual side effects. However, any changes in the types or dosages of medications that you use must be made under the supervision of your doctor. Speaking to him or her openly about this is your first step. Carolina Valdivia, MD
REFERENCES:Schweitzer I, Maguire K, Ng C. Sexual side-effects of contemporary antidepressants: review. Australian and New Zealand Journal of Psychiatry. 2009;43(9):795-808. Sweetman SC. Martindale: The Complete Drug Reference, 36th Ed. London: Pharmaceutical Press, 2009.
A number of visitors have written to me asking for recommendations pertaining to eye-care products and books for obtaining more information. I have joined with Amazon.com to create a dependable resource for books and products. You can find these materials at the Eye-Care Store. My goal in answering your questions is to provide you with information, clear up misconceptions, and to explain options so that you can have an informed conversation with your doctor. However, under no circumstances should my response to your question be considered a substitute for ongoing consultation and examination with your doctor. Since I have not examined you, I only can speak in terms of generalities, whereas your doctor has sufficient clinical details to evaluate your case specifically.
Return from Anorgasmia to Answer My Health Question
|
The technical medical term for what you are describing is anorgasmia. It refers to either a difficulty or an inability to achieve an orgasm. Several things can cause anorgasmia. Among these are diabetic neuropathy, multiple sclerosis, pelvic trauma, hormonal imbalances, spinal cord injuries, and cardiovascular disease.