Both men and women can experience problems in any of these phases. Low desire, lack of swelling and lubrication in women, erectile dysfunction, premature, retrograde or absent ejaculation, anorgasmia and painful sex not only affect the individual, but also impact on their partner. Whether patients report their sexual problems depends on several factors, including whether the patient is comfortable disclosing these problems, and whether the clinician is willing to ask about sexual issues and does so in a sensitive way.
Conversely some may blame their drugs for sexual problems which are due to relationship difficulties or other stressors. Some doctors consider that asking patients if they had noticed any sexual adverse effects from their drugs may 'suggest' them to the patient, and possibly result in non-adherence. Patients attributing their sexual problems to their drugs are less likely to continue the treatment even when necessary for their health.
Hypertension is associated with sexual dysfunction. The angiotensin II receptor antagonist, valsartan, was associated with improved sexual desire and fantasies when compared with the beta blocker atenolol in women with hypertension. Aside from the medicine, it is important to be aware of the effects of psychiatric problems on the patient's relationship and address the psychosocial issues.
Many antidepressants cause sexual difficulties. Tricyclic antidepressants inhibit sexual desire and orgasm. Monoamine oxidase inhibitors are also associated with sexual dysfunction. Although moclobemide was reported to increase sexual desire, 24 the doses used in that study were considered subtherapeutic. Other antidepressants such as venlafaxine and mirtazapine have variable negative effects on all aspects of sexual function.
Initial reports on agomelatine in both male and female patients with major depressive disorder suggested significant antidepressant efficacy without significant sexual adverse effects. However, more recent reviews of the sexual effects are conflicting. Some antipsychotics may affect sexual function more than others see Table 2. Men taking antipsychotics report erectile dysfunction, decreased orgasmic quality with delayed, inhibited or retrograde ejaculation, and diminished interest in sex.
Women experience decreased desire, difficulty achieving orgasm, changes in orgasmic quality and anorgasmia. Dyspareunia, secondary to oestrogen deficiency, can result in vaginal atrophy and dryness. Galactorrhea is experienced in both sexes. A recent observational study of schizophrenia found that in patients with diminished sexual desire, ziprasidone was preferred over olanzapine.
This causes hyperprolactinaemia with subsequent suppression of the hypothalamic—pituitary—gonadal axis and hypogonadism in both sexes. This decreases sexual desire and impairs arousal and orgasm. It also causes secondary amenorrhoea and loss of ovarian function in women and low testosterone in men. Before commencing dopamine receptor antagonists it is useful to establish a baseline prolactin, as subsequent elevation can then be attributed to the drug.
Non-drug induced causes of hyperprolactinaemia such as pituitary tumours should be considered in patients on dopamine receptor antagonists. Sexual dysfunction is common in patients on antiepileptic drugs. Oral contraceptives decrease circulating free testosterone. It is postulated that this decreases desire in women, although there is little evidence to support this.
The impact of malignancy and its treatment on both the individual and his or her partner can have a significant negative influence on their sexual relationship. Many of the cancer treatments can lead to sexual dysfunction. As common examples, long-acting gonadotrophin-releasing hormone agonists used for prostate and breast cancer result in hypogonadism, with subsequent reduction in sexual desire, erectile dysfunction in men 42 , vaginal atrophy and dyspareunia in women as well as orgasmic dysfunction.
Men who present with symptomatic benign prostatic hyperplasia and lower urinary tract symptoms have an increased incidence of sexual dysfunction. Overall, Antiandrogens such as cyproterone acetate, cimetidine, digoxin and spironolactone block the androgen receptor. This reduces sexual desire in both sexes, 45 and affects arousal and orgasm. Steroids such as prednisone used for many chronic inflammatory disorders result in low serum testosterone which reduces sexual desire and causes erectile dysfunction.
Many other drugs including antihistamines, pseudoephedrine, opioids and recreational drugs may cause sexual dysfunction and should be considered when assessing the patient. Non-drug approaches include therapy with a clinical psychologist who understands sexual dysfunction.
A variety of strategies have been tried to reverse drug-induced sexual dysfunction, including drug switching, dose reduction and drug holidays. Taking a phosphodiesterase type 5 inhibitor in anticipation of intercourse has become the standard of care for men. In women, sildenafil has shown promise for reversing the inadequate lubrication and delayed orgasm induced by selective serotonin reuptake inhibitors. Changing to an alternative drug is recommended for men and women taking antihypertensives.
Alpha blockers, ACE inhibitors and calcium channel blockers are not considered to cause erectile dysfunction, 54 while several studies have suggested that angiotensin II receptor antagonists may even improve sexual function. Beta 1 -selective beta blockers such as nebivolol may have potential advantages in these patients.
In patients taking antipsychotics, establish the cause of the hyperprolactinaemia then consider dose reduction or switching to prolactin-sparing drugs. Relationship counselling and addressing patient-specific concerns can be useful. In women, oestrogen cream can alleviate local symptoms such as atrophic vaginitis and dyspareunia.
If a woman complains of sexual dysfunction while on an injectable progestogen, another form of contraceptive can be considered. Suggested solutions to gabapentin-induced anorgasmia include dose reduction, timing of dose away from planned coitus until anorgasmia no longer occurs, substitution with a different medication, and co-administration of other medications. Understanding both the impact of a disorder and the effects of its treatment on both the patient and their partner are critical to providing good clinical care.
It is important for the clinician to acknowledge and encourage discussion regarding sexual function, as well as enquire about the impact of drugs on sexual function. This will ensure patients and their partners understand their sexual difficulties and treatment options. Reasonable care is taken to provide accurate information at the time of creation.
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Medical Specialist. Other health profession. Which of the following best describes how frequently you visit this site? This is my first visit. Often e. Occasionally e. Rarely e. Drug-induced sexual dysfunction in men and women. Aust Prescr ; Article Authors. Subscribe to Australian Prescriber. Summary Many medical conditions and their treatments contribute to sexual dysfunction.
Introduction Several classes of prescription drugs contribute to sexual dysfunction in men and women Table 1. Talking to the patient Whether patients report their sexual problems depends on several factors, including whether the patient is comfortable disclosing these problems, and whether the clinician is willing to ask about sexual issues and does so in a sensitive way.
Treatments for hypertension Hypertension is associated with sexual dysfunction. Psychoactive drugs Aside from the medicine, it is important to be aware of the effects of psychiatric problems on the patient's relationship and address the psychosocial issues. Antidepressants Many antidepressants cause sexual difficulties. Contraceptives Oral contraceptives decrease circulating free testosterone. Treatments for cancer The impact of malignancy and its treatment on both the individual and his or her partner can have a significant negative influence on their sexual relationship.
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To do. D-Bal is also believed to increase testosterone levels in the body, which helps build muscle mass. Steroid Gynecomastia Pictures Gynecomastia can also be triggered by an adverse reaction to antibiotics, certain other drugs, anabolic steroids and herbal products. And many are not ready to endure this long struggle and turn to quicker methods like steroids to hasten the process.
While many people trust the use of anabolic steroids for building muscle mass. The misuse of anabolic steroids can cause long-term side effects. Some people take anabolic. Ad The best legal steroids offer men a natural alternative to illegal anabolic steroids. The medical name for most anabolic steroids is. Classed as a category C drug, they can only be sold by pharmacists to someone with a prescription.
It is illegal to import or possess the drugs, if it is believed you are going to sell them. The penalty can be a heavy fine or even prison time. Steroids can be taken by an injection into the muscle, in pill form or they can also be applied by use of a cream or gel. Side effects to steroid abuse for men are a reduced sperm count, infertility, shrunken testicles, erectile dysfunction, baldness.
Increased aggression among users have been documented across the world since the s by researchers examining what is sometimes labelled 'roid rage'. Experts have also highlighted how a disturbing number of bodybuilders have been involved in murders compared with other sportsmen. In an article in the American magazine Sports Illustrated highlighted the large number of bodybuilders jailed for killings compared with other athletes.
Share this article Share. Effects of anabolic steroids in men can include: reduced sperm count infertility shrunken testicles erectile dysfunction baldness breast development increased risk of developing prostate cancer severe acne stomach pain Source: NHS Choices. Share or comment on this article: Middle-aged men turn to steroids to boost their libido e-mail 8.
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Bear in mind that the pill can also increase your sex drive. Proscar is used to treat benign prostatic hyperplasia or BPH, better known as an enlarged prostate. The active ingredient in the drug is finasteride, which prevents testosterone from converting into its active form. Lower testosterone can mean a lower libido.
An alternative treatment for BPH is a procedure known as a transurethral resection of the prostate. This widely performed one-hour operation involves slipping a tube up the urethra and removing a portion of the prostate. That could take care of the prostate problems and the need for medication. And there have been reports that the effects can last even after discontinuing the drug, says Dr. Over-the-counter antihistamines, especially diphendyramine Benadryl and chlorpheniramine Chlor-Trimeton , may alleviate your allergies, but temporarily affect your love life.
The solution here could be as simple as carefully timing when you take the drug. You may be taking antihistamines and lowering your libido without knowing it. If you are using marijuana legally and having sex drive problems, talk with a healthcare provider about alternatives for pain and nausea, two common reasons people use marijuana-the-drug. Tegretol can be a game changer for people who have seizures and even for some with bipolar disorder.
But the price can be reduced sexual desire. Tegretol and other drugs like it work by preventing impulses from traveling along the nerve cells, but therein lies the problem. An orgasm is similar to a seizure—in both, sensory input triggers a body response—says Dr.
Goldstein, so medications that dampen nerve impulses can also reduce pleasurable sensations. In short, the things that used to stimulate you just may not do it for you any more. If an anti-seizure drug is affecting your libido, ask your doctor about an alternative medication. Opioid medications can be a blessing in terms of pain relief, but a curse in terms of addiction and sex drive. Studies have shown that opioids such as Vicodin, OxyContin, and Percocet, can lower testosterone, which can affect your libido.
Testosterone therapy—perhaps in the form of a gel—may help men taking opioids for pain who have libido problems, one study found. Tens of millions of Americans use beta blockers such as propranolol and metoprolol with great benefit to their hearts, but not necessarily their sex lives.
In rare cases, even eye drops containing the beta blocker Timolol used to treat glaucoma can decrease libido, says Dering-Anderson. But there are many beta blockers on the market. They all lower blood pressure, but in different ways.
Talk to your doctor to find one that works for all of you. But the underlying anxiety could be the real problem. In that case, the medication might calm your anxiety enough to actually enjoy sex, says Dering-Anderson. This article originally appeared on Health. Contact us at letters time. Health Low Libido? Please update your billing details here to continue enjoying your subscription. Your subscription will end shortly.
Please update your billing details here to continue enjoying your access to the most informative and considered journalism in the UK. Accessibility Links Skip to content. Menu Close. Log in Subscribe. Middle-aged men use steroids to boost sex drive. Oliver Moody , Science Correspondent. Monday April 03 ,