Archive for the ‘low libido’ Category

FAQs on Erectile Dysfunction

December 5, 2015

It often is a mystery about men are able to achieve and hold an erection.  Even more mysterious is what are the causes of failure of erections and to fix the problem.  It is not uncommon for me to feel uncomfortable broaching the topic with their physician.  Fortunately, after the introduction of oral medication to treat impotence or erectile dysfunction in 1999, men are talking about their problems in the bedroom with their physicians.

In this blog I will discuss some of the most frequently asked questions about ED and the treatment for this common condition that impacts over 14 million American men.

  1. Why does Viagra fix the problem?

An erection requires an increase in the blood supply to the penis and more blood has to rush into the chambers of the penis than comes out of the penis.  When this happens, an erection will occur. Viagra helps blood vessels relax and increases the blood supply to the penis.

  1. Does the male hormone, testosterone, have a role in the erection process?

Testosterone acts on a series of different areas of the body to enhance bone development, muscle growth, sexual interest and function. Testosterone is primarily responsible for the libido or sex drive.  The testosterone level slowly decreases at a rate of about 1% a year starting around 25.  By middle age, most men start experiencing signs and symptoms of testosterone deficiency and men often need hormone replacement therapy.  This can be accomplished with injections, topical gels, or pellets of testosterone inserted under the skin.

  1. Why does sex feel good?

There is a high concentration of nerve endings in the penis and vagina, which triggers stimulation and orgasm. Dopamine is triggered and there is a pleasant feeling in the brain during ejaculation. It could also be an evolutionary thing. When we were cavemen with only animal instincts, the fact that sex feels good encouraged us to reproduce to keep the species going.

  1. Do sexually transmitted disease cause erectile dysfunction?

Gonorrhea and chlamydia are both sexually transmitted diseases that are caused by direct and unprotected sexual contact. Both STDs live in reproductive genital tracts of men and women and can be cured with antibiotics. If both STDs go untreated, it can lead to infection that will lead to infertility in men but usually does not cause erectile dysfunction.

5 Why does sex hurt?

The obvious reason is if the man’s penis is much larger than a woman’s vagina opening. The other possibility is that women have a decrease in lubrication of the vagina and the friction is a source of pain and discomfort usually for the men but also for the male partner as well.

Bottom Line:  Impotence is a common condition especially in middle age or older men.  Treatment is available and most men can be helped.  Talk to your doctor.

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Low Testosterone And Depression: there is a relationship

September 27, 2015

Testosterone is more important that sex drive\libido, erections, and energy levels. A new study has documented low testosterone and testosterone that is the lower limits of normal may be associated with depression.

The study from the George Washington School of Medicine and Health Sciences in Washington, DC. included 200 adult men, who were referred for borderline total testosterone levels between 200 and 350 ng/dL. Doctors typically treat men for hypogonadism or low T if they have symptoms of low testosterone and their testosterone levels are below 300 ng/dL.

The results show that more than half (56%) of the men had depression or depressive symptoms, which is significantly higher than rates seen in general populations. A recent survey of US adults found that 6% of those who are overweight or obese were depressed. One-quarter of the men used antidepressants.

Also worth noting, the men had high rates of overweight or obesity and physical inactivity. Common symptoms were erectile dysfunction, decreased libido, fewer morning erections, low energy, and sleep disturbances.

The study authors concluded that clinicians should consider screening for depression/depressive symptoms and overweight and unhealthy lifestyle risk factors in men referred potential hypogonadism.”

Testosterone replacement therapy can improve the signs and symptoms of low testosterone in these men who have documented low testosterone levels.

The researchers published their results online on July 1, 2015 in the Journal of Sexual Medicine.

Low Testosterone and Sexual Problems From Pain Pills

May 4, 2015

Men with chronic pain in any location but commonly for low back pain who use potent analgesic (Oxycontin, Percocet, Oxycodone) medication are at risk for lowering the testosterone level or the hormone produced in the testicles that is responsible for sex drive or libido. Consequently some men who use pain medications for a long period of time may have sexual problems, lethargy and fatigue.

Narcotic pain tablets such as Percocet™, Oxycodone™, Roxycodone™ and Oxycontin™ come with severe adverse side effects associated with narcotics addiction.

Adverse Effects of Long Term Pain Pills (Opiates)
Narcotic Pain Pills (opioids) are highly addictive with severe adverse effects related to drug withdrawal. Opiate containing narcotic pain pills are highly effective for short term use for pain, but were never intended for long term use. Over time, these drugs cause profound suppression of the endocrine system, and in men, profound inhibition of testosterone production.

Low Testosterone Goes Largely Unrecognized
Although quite common, opioid-induced androgen deficiency and has gone largely unrecognized by the medical profession. Low testosterone is caused by opioid drug inhibition of LH (Luteinizing Hormone), a pituitary hormone involved in testosterone production, as well direct inhibition of testosterone production, itself. Similarly, there is also inhibition of the entire endocrine system, and adrenal hormone suppression. Symptoms of low testosterone include fatigue, depression, hot flashes, night sweats, diminished libido, erectile dysfunction, and diminished sexual arousal and satisfaction. Men may also develop osteoporosis, anemia, and diminished muscle mass.

These drugs also have a negative impact on women. Women who consume opioid-pain pills will stop having menstrual cycles and will notice greatly diminished libido (sex drive).
Testosterone Treatment Effective and Recommended by Mainstream Medicine
Administration of both topical (transdermal) testosterone and injectable testosterone has been studied and found effective for men with low testosterone on pain pills.

Opiate Detoxification Program is Essential
The reality is that hormone supplementation and nutritional supplementation for the long term opiate pain pill user is only a temporary band aid. To fully restore health, the opiate addiction must be addressed and the patient must ultimately get off the pain pills. Drug withdrawal may be difficult because of severe drug withdrawal symptoms. Therefore, we refer the patient to a center that specializes in narcotics detoxification, and urge the patient to strongly consider this option.

Bottom Line: Opioid pain medication is helpful for short term use. However, use of these addicting drugs for chronic pain can result in sexual problems in both men and women. For those who have sexual problems, consider seeing a pain management specialist, find alternative methods of pain relief, and using testosterone replacement therapy.