Sexual dysfunctions are commonly seen in women on selective serotonin reuptake inhibitors
(SSRIs). The complexities of female sexual functioning are reflected through modulation of inter-
playing factors like the neuropsychophysiological factors, inter-personal and relationship issue,
psychiatric co-morbidities and physical disorder. The incidence of SSRIs-induced FSD is difficult to
estimate because of the potential confounding effects of SSRIs, presence of polypharmacy, marital
effect, socio-cultural factors and due to the design and assessment problems in majority of the studies.
The exact mechanism of FSD-induced SSRIs is unknown. It has been postulated that although SSRIs
may modulate other neurotransmitter system such as nitric oxide (NO), noradrenergic and dopamine
in inducing FSD. In the present review, we highlight current evidence regarding potential mechanism
of SSRIs in causing FSD, which include low sexual desire (low libido), arousal difficulties (lack of
lubrication), and anorgasmia. The specific association of FSD to SSRI use, has not been ellucidated.
The relationship is dose-dependent, and may vary among the groups with respect to mechanism of serotonin
and dopamine reuptake, induction of release of prolactin from the pituitary gland, anticholinergic
side-effects, inhibition of NO synthesis and emotional-memory circuit encryption for sexual
experiences. Various interventional strategies exist regarding the treatment of SSRI-induced FSD and
this includes tolerance, titration dosage, substitution to another antidepressant drug and psychotherapy.
There is a need of better understanding of SSRIs-induced FSD for better treatment outcome.