300 reports of sexual dysfunction that outlasted the drug, from 37 countries and three unrelated drug classes
A case series from an adverse-event website: after serotonin reuptake inhibitors, finasteride-type drugs or isotretinoin, people described genital anaesthesia, weak or pleasureless orgasm, lost libido and impotence. Description, not count.
Weak or heavily disputed. Treat as a question, not an answer. how we score evidence
Caveat on this rating: Self-submitted reports to a website built to collect them, assembled by the website's founder. A case series describes; it cannot count incidence or establish causation in any case. The cross-class overlap is unexplained. No rate, mechanism or treatment.
What the persistent syndrome looks like when hundreds of reports are laid side by side, and why a case series cannot say more than that.
Significant findings
Healy, Le Noury and Mangin used reports submitted to RxISK.org, a global adverse-event reporting website, "to establish the clinical features, demographic details and clinical trajectories" of persistent sexual difficulties after three different kinds of treatment: serotonin reuptake inhibiting antidepressants, 5-alpha-reductase inhibitors (finasteride-type drugs), and isotretinoin.
"We report on 300 cases of enduring sexual dysfunction from 37 countries following 14 different drugs." Some features were specific to the antidepressants, "such as the onset of premature ejaculation and persistent genital arousal disorder." But "there was also a significant overlap in symptom profile between the drug groups, with common features including genital anaesthesia, pleasureless or weak orgasm, loss of libido and impotence. Secondary consequences included relationship breakdown and impaired quality of life."
The conclusion: "These data point to a legacy syndrome or syndromes comprising a range of disturbances to sexual function. More detailed studies will require developments in coding systems that recognise the condition(s)."
The other direction
A case series is the weakest design for the question people bring to it. Three hundred self-submitted reports to a website built to collect them describe what the syndrome looks like; they cannot say how many people who take the drugs get it, and they cannot show that the drug caused it in any individual. The first author founded the website the cases came from. The overlap across three unrelated drug classes is the paper's most interesting observation and also its hardest to interpret: it may point to a shared mechanism, or to a shared way people describe sexual loss.
What this does not show
No rate, no mechanism, no treatment. It does not say the syndrome is common or rare, and it does not say anyone should stop or avoid a drug. It is the description that a regulator's warning sits on top of, not the measurement that would tell a person their odds.
Worth asking
Are there sexual side effects on this drug that you have seen persist, and what would you want me to report and when?
Source
Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases — Healy D, Le Noury J, Mangin D (2018)
Indexed peer-reviewed journal
Read the source: https://doi.org/10.3233/JRS-180744
DOI: 10.3233/JRS-180744
How this was scored
- Study design
- Case series or case report
- Funding
- Funding not disclosed
- Published in
- Indexed peer-reviewed journal
- Sample size
- 300
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published September 29, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "contested". Weak or heavily disputed. Treat as a question, not an answer. It scores 34 out of 100 on our published rubric. One caveat travels with that badge: Self-submitted reports to a website built to collect them, assembled by the website's founder. A case series describes; it cannot count incidence or establish causation in any case. The cross-class overlap is unexplained. No rate, mechanism or treatment. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases — Healy D, Le Noury J, Mangin D (2018). Published in: Indexed peer-reviewed journal. DOI: 10.3233/JRS-180744. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Case series or case report. Funding: Funding not disclosed. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.