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Double X Male Enhancement Depressed patients most often complain of decreased sex drive , less frequently erectile dysfunction and ejaculation, as well as difficulty in achieving orgasm. There is a mutual dependence between the state of depression and the occurrence of sexual dysfunctions, i.e. the presence of one of these states intensifies the symptoms of the other, and effective treatment may in turn lead to improvement. Disorders such as post-traumatic stress disorder and anxiety disorders are also associated with the frequent occurrence of sexual dysfunctions. The influence of other drugs that may cause such side effects (eg drugs used in cardiovascular diseases), additional somatic diseases (such as diabetes, hypertension), used psychoactive substances (nicotine, alcohol) should also be taken into account. Most researchers believe that SSRIs cause sexual dysfunction as a side effect in approximately 30-50% of patients. 4. Proceedings in sexual dysfunction and antidepressant treatment Knowledge about the physiology of sexual function is incomplete. In response to sexual stimuli, the central nervous system plays a key role. It involves a number of psychogenic, neurogenic, vascular and hormonal factors that are under the control of the hypothalamus, limbic system and cerebral cortex. Antidepressants have a side effect on sexual function. This depends on the elevated level of serotonin and prolactin, lowered dopamine, blockade of alpha-adrenergic and cholinergic receptors and reduced nitric oxide synthase activity. In the prevention and treatment of sexual dysfunctions, it is important to eliminate substances that may contribute to their formation, eg nicotine and alcohol . A healthy lifestyle, moderate physical activity and weight loss in the case of overweight are important. Psychotherapy, which allows you to reduce the severity of symptoms, may also help. Pharmacological treatment of sexual dysfunctions occurring during SSRI may include: reducing the dose, changing the preparation to another with a different mechanism of action, using preparations intended for the treatment of sexual dysfunctions. It is worth choosing anti-depressants in such a way that the side effects of medications, eg in the form of sexual dysfunctions, do not make it possible to resign patients from the treatment.