Recognition and assessment of sexual dysfunction associated with depression.

Recognition of sexual dysfunction associated with depression or its treatment is critical for patient satisfaction and medication compliance. This report reviews relevant literature related to types of sexual problems, the etiology of sexual dysfunction, prevalence rates, barriers to assessment, and available instruments for evaluating sexual functioning in individuals with depression. Evaluation of sexual functioning should include examination of each phase of the sexual response cycle, with classification of sexual disorders as described in the DSM-IV. Sexual functioning requires both an adequate hormonal milieu and appropriate neurotransmitter functioning. Evaluation of sexual functioning should include a sexual history, current level of sexual functioning, history and current diagnoses of medical and psychiatric illnesses, evaluation of medications and/or other substances taken, indicated endocrine measures, and targeted physical examination. Appropriate evaluation of sexual functioning associated with depression could help reduce the enormous societal costs of this disorder.