Frequency of self-reported persistent post-treatment genital hypoesthesia among past antidepressant users: a cross-sectional survey of sexual and gender minority youth in Canada and the US. (2023)
Frequency of self-reported persistent post-treatment genital hypesthesia among past antidepressant users: a cross-sectional survey of sexual and gender minority youth in Canada and the US
AUTHORS
Yassie Pirani, Jorge Andres Delgado-Ron, Pedro Marinho, Dr. Amit Gupta, Emily Gray, Sarah Watt, Kinnon R Mac, Kinnon, travis_salway@sfu.ca
Corresponding author:
Travis Salway
Faculty of Health Sciences
Simon Fraser University
Email: travis_salway@sfu.ca
ORCID: 0000-0002-5699-5444
Abstract
Purpose: Post-SSRI Sexual Dysfunction (PSSD) has been increasingly identified as an iatrogenic syndrome of enduring sexual dysfunction following the use and discontinuation of some antidepressants. We aimed to estimate the frequency of reporting persistent post-treatment genital hypesthesia (PPTGH) among past users of psychiatric treatments, particularly antidepressants. Methods: We used a subsample of UnACoRN, a binational survey of mostly sexual and gender minority youth aged 15 to 29. We included all participants with a history of psychiatric drug use. We excluded individuals with genital surgeries. The analysis involved chi-square tests for initial group comparisons and logistic regression. We used logistic regression among those who had stopped taking medication to estimate the odds of PPTGH by drug type, adjusting for age, sexual experience, sex assigned at birth, hormone treatment, and depression severity in three nested models. The final odds ratio was converted to the relative risk scale. Results: Among 3127 past or current psychiatric drug users, 632 reported genital hypesthesia. They were older, with a greater proportion reporting sexual experience, residence in Canada, male sex assignment at birth, use of hormonal therapy, and past diagnosis of depression. The frequency of PPTGH among antidepressant users was 11.3% (101/895) compared to 0.7% (1/139) among users of other medications, equivalent to a relative risk of 10.25 (95% CI: 2.18 to 81.54). Conclusion: Past use of antidepressants is associated with a substantially increased frequency of reporting PPTGH—the cardinal symptom of PSSD—in two countries where SSRI/SNRI medications account for 80% of antidepressant prescriptions. We call for standardized international warnings and transparent, informed consent, especially among younger patients. Future research should expand upon our efforts to estimate the risk of PSSD by including all the proposed diagnostic criteria, including documentation of temporal changes in PSSD-related symptoms before and after treatment (≥3 months).