Thomas David R
Division of Geriatric Medicine, Saint Louis University Health Sciences Center, St. Louis, MO 63104, USA.
Clin Geriatr Med. 2003 Aug;19(3):553-62. doi: 10.1016/s0749-0690(02)00101-5.
There seems to be a reluctance to self-report sexual dysfunction during clinical interviews. The rate of reported sexual dysfunction increases when information is sought aggressively in the clinical interview. The relationship to a specific therapeutic agent, however, can be clouded by the patient's perception and coexisting morbidity. Most of the data relating sexual dysfunction to specific drugs are anecdotal. The strongest proof of a casual effect is improvement in sexual function after withdrawal of the medication. Most of the adverse sexual effects of commonly used medications can be predicted from a simplified understanding of the human sexual response and physiologic mediators. Alternative therapeutic agents can be substituted by understanding these physiologic mechanisms and a careful clinical interview. Although polypharmacy is a problem for older persons, in some cases sildenafil can be used to correct drug-induced impotence.
在临床访谈中，患者似乎不愿自我报告性功能障碍。当在临床访谈中积极探寻相关信息时，报告的性功能障碍发生率会增加。然而，性功能障碍与特定治疗药物之间的关系可能会因患者的认知和并存疾病而变得模糊。大多数将性功能障碍与特定药物相关的数据都是传闻性的。因果关系的最有力证据是停药后性功能得到改善。通过对人类性反应和生理介质的简单理解，可以预测常用药物的大多数不良性影响。通过了解这些生理机制并进行仔细的临床访谈，可以替代使用其他治疗药物。虽然多种药物并用对老年人来说是个问题，但在某些情况下，西地那非可用于纠正药物引起的阳痿。
