From my life long experience with medications in pill or injection form. Paxil was the worst, there was absolutely NO sex drive or desires of any kind period. Flomax didn't interfere with erections, but no ejaculate during or after orgasm.
My MtF transition HRT medications and injections I'll put in a different category per say. Because of larger to smaller or vice versa dosage the effects where different in most cases.
Spironolactone (injection) every two weeks for the testosterone blocker was very hard to achieve erections if any at the higher dosage. However could orgasm with little to no ejaculate. The lower dosage (pill) was only used the first month just lowering sex drive.
Female hormone injection every two weeks, the first month was a smaller dosage. It's hard to say because of the Spironolactone was doing it's thing and female hormone doing it's.
The dosage was largely increased after the first month until I had my orchictomy. Again it's hard to say, my moods where different one minute to the next at most times.
After my orchictomy my female hormone injection dosage was lowered to half dosage for two weeks. I stopped taking the Spironolactone. I did notice more sex drive.
The female hormone injection was increased to three quarters dosage because of level of hormones from blood test. My sex drive went into overdrive which currently still is.
Just a little note: I'm a test and study patient thru a university for research on a new transgender affirmation hormone injection that hasn't been cleared by the FDA. The patients DO NOT know anything about this hormone injection including name, ingredients, or dosage used for confidential purposes.
Patient get any related blood test, lab work, medication and or injections, exams, consultation, and orchictomy by choice for free. I also get SRS bottom surgery done at the university for half price.