Lithium and male sexual function in affective patients

The aim of the present study was to evaluate sexual function and behavior in male patients who take lithium. Participants included 35 bipolar and schizoaffective men, aged 43.3 ± 9.6 years, who were in euthymic state and were receiving lithium as the sole medical treatment. Eleven patients (31.4%) reported sexual dysfunction on at least two items of the sexual function questionnaire. Notable results were reduction in frequency of sexual thoughts and loss of erection during sex in 23 and 20% of patients, respectively. Difficulties in achieving and maintaining erections (ease of arousal) were reported in 14% of patients. Nevertheless, almost all patients reported preserved pleasure during sexual activity and were satisfied with their sexual performance. There was no difference in serum lithium levels in patients with and without sexual dysfunction. No statistical correlation was found between sexual function scores and serum lithium levels. Lithium therapy may impair desire and arousal, yet it does not appear to have a major impact on patient self-satisfaction or subjective sense of pleasure during sexual activity. The degree of sexual dysfunction as reported in the present study was not a source of distress to patients and did not cause noncompliance.