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Patients with depressive disorders frequently have concurrent sexual problems. Sexual dysfunction is often masked by the mood disorder, and many patients, have difficulty discussing these problems openly. Consequently, sexual dysfunction often is detectable only by very careful inquiry. The relationship between sexual dysfunction and depressive disorders is further complicated by antidepressant therapy, which itself may cause sexual dysfunction, increasing the risk of noncompliance and relapse. Thus, it is critical for physicians to assess sexual function during the initial evaluation and throughout treatment. Although sexual dysfunction secondary to antidepressants is a perplexing and common clinical problem, is important to realize that effective antidepressant treatment does not need to compromise sexual function.