Posts Tagged ‘decreased libido’

Testosterone, Depression, and SSRI’s or Anti-Depressants-What’s the Connection?

December 21, 2015

Many people that take antidepressants, specifically SSRI’s (selective-serotonin reuptake inhibitors), find out that they have abnormally low testosterone. So what does this all mean? Did the initial low testosterone lead the individual to become depressed and go on an antidepressant? Or did the treatment with an antidepressant actually slowly reduce the individual’s natural ability to produce testosterone?

It really is a “chicken vs. egg” type argument in regards to whether low T caused depression or an antidepressant caused low T. Unfortunately there is no clear-cut scientific answer as to whether the antidepressant you took caused your testosterone to be lowered.

With that said, new research comes out all the time finding new things about antidepressants (SSRI’s) – they really aren’t well understood. Many antidepressants medications are now linked to development of diabetes, birth defects, etc. Although there are no formal studies to link antidepressants with low testosterone, many people taking these drugs are convinced that they are the root cause.

It could have been that the lower testosterone was what caused the person to feel depressed in the first place. The low T could have also merely been a coincidence among those who are depressed – after all, having low T is a pretty common issue.

Antidepressants and Testosterone: Many people taking antidepressants experience low testosterone. Similarly, many people with low testosterone are taking antidepressants. These two factors could also occur independently. In other words a person may develop low testosterone while on an antidepressant without the antidepressant being the cause. 



Depression and Testosterone: Many people may be experiencing depression as a result of low testosterone. Similarly many people may be experiencing low testosterone as a result of depression. Additionally, these two factors could be totally unrelated and independent of each other. In other words the depression could have nothing to do with low T and vice versa.
Depression and sex drive – Many people with depression tend to have lower than average sex drives. It is the depression that is thought to lead to disinterest in pleasurable activities like sex. People may be in such a depressed, low level of arousal, that they don’t feel like having sex. Therefore in this case, it could be that the depression and not testosterone is causing reduced sexual interest.
Testosterone and sex drive – It is well known that healthy testosterone levels are linked with a healthy sex drive. Men that have low T tend to have less fuel for sex, erectile dysfunction, and other performance issues. If your testosterone level were to be lowered, the natural result would be a reduced sex drive. This reduced sex drive could be linked to depression – therefore testosterone could play a role.
Low testosterone causing depression? – Individuals with lower than average levels of testosterone could be experiencing depressive symptoms as a result of their low T. Studies have found that among men with abnormally low levels of T, testosterone therapy helped reduce symptoms of depression. For this reason it is important to rule out all causes of depression (including low T) before you get on an antidepressant.
Antidepressants and low testosterone – It is well documented that antidepressants can affect hormones. Therefore some hypothesize that hormonal changes can influence our sex drive. It is not known whether antidepressants are the culprit behind lowering levels of testosterone. Many people that have taken SSRI’s believe that the drugs they took lowered their testosterone.
Bottom Line: There is no question that there is a relationship between testosterone and depression. I cannot say for certain that low testosterone is a result of the use of SSRIs. However, if you are taking SSRIs and you are experience a low sex drive or libido, it is very easy to ask your doctor to obtain a blood testosterone test. If it is low, treatment is easily accomplished with either testosterone injections, topical gels or pellets.

Little Blue Pill (Viagra) For Men and Now A Little Pink Pill (Addyi) For Women

August 24, 2015

Now women with sexual dysfunction will have a solution to their problem with decrease in libido or sex drive. A 2002 study found that up to one-third of adult women might experience hypoactive sexual desire disorder, a technical term for when women lack sexual desire or fantasy.
Recently the FDA approved flibanserin, which will be sold as Addyi, for the treatment of sexual dysfunction in premenopausal women.
This is the first FDA approved treatment for sexual desire in men or women.

Today’s approval provides women distressed by their low sexual desire with an approved treatment option. The approval is not without warnings. In fact, the agency approved the drug with a risk warning to ensure safety. Of greatest concern, an increased risk of severe low blood pressure, so low it can cause a temporary loss of consciousness. This is more of a concern in patients who drink alcohol while taking the drug. The doctor will be required to warn patients of the risks of consuming alcohol while taking Addyi.

Addyi is frequently referred to as “female Viagra” because it’s a pill for sexual dysfunction in women. However, experts say it’s a misnomer to describe it as such because it works in a distinctly different way to target the brain.
Viagra treats erectile dysfunction, a physical problem, and does not induce sexual desire. Addyi works on the central nervous system, which is why it’s in the same category as an antidepressant.
Another difference is that men take Viagra as needed before a sexual encounter, and women will need to take Addyi once every night. Taking it at night will reduce the likelihood of adverse reactions from low blood pressure and sleepiness or depression from a depressed central nervous system.
Other common side effects include dizziness, nausea, fatigue, insomnia and dry mouth.
In clinical trials, women taking the drug experienced a 37% increase in sexual desire.

Addyi will cost about the same per month as a one month supply of Viagra for men.

Bottom Line: Nearly as many women as men suffer from sexual dysfunction. Addyi is the first drug to address this problem in women. However, women need to be cautious about the use of this new medication. For more information, speak to your physician.

Non Medical Ways to Boost Testosterone Levels

November 9, 2014

Testosterone is the male hormone produced in the testicles and it is responsible for man’s sex drive. Low testosterone levels can impact a man’s sexual performance. This blog will discuss life-style changes that men can make to improve their testosterone levels.

The sex hormone testosterone is often touted as helping men maintain their vitality and virility, but levels begin to dip naturally by about 1 percent a year after age 30. Signs that your testosterone may be declining more rapidly include loss of energy, decreased sex drive, irritation or anger, and trouble sleeping.
Although testosterone supplementation is effective, there are risks and side effects that make life style changes a more attractive alternative. There are many tried and true drug-free and hormone-free ways to maintain testosterone levels.

Deep Six the Sauce (Alcohol)
A glass of wine with dinner is no problem, but overdrinking is not a good idea. Moderate alcohol consumption for men is a max of two drinks a day, with one being a 5-ounce glass of wine.

Shed Some Pounds
Being overweight or obese can increase risk for heart disease and certain cancers, but extra weight also increase the risk for low testosterone levels. Research published in Diabetes Care in June 2010 showed that 40 percent of obese men had lower-than-normal testosterone readings, and this percentage increased to 50 percent among obese men with diabetes. Weight loss can be a hormone-free way to combat low T. A benefit of weight loss for obese men is that the penis will appear to be longer because of the loss of the abdominal fat. I usually tell men that every 30 pound weight loss increases the length of the penis by 1.5 inches.

Send Out a Stress SOS
A study done at the University of Texas at Austin in 2010 suggested that the stress hormone cortisol may block the beneficial testosterone. When our stress levels are up, our testosterone can go down.

Regular exercise helps reduce stress levels as well as help you maintain a normal weight, so it packs a double whammy against low testosterone levels. Other stress reduction techniques, like deep breathing, can also serve as natural testosterone support.

Take a Big Dose of Vitamin “E”-Exercise
Exercise can help maintain your testosterone levels and avoid some of the symptoms of low T.
Research in the September 2011 issue of the Journal of Strength and Conditioning Research backs this up. The study showed that a 4-week sprint-interval training program helped boost testosterone levels in a drug-free fashion among wrestlers.

Sleep And Sex
A small study conducted at the University of Chicago School of Medicine found that men who slept less than five hours a night for one week had lower levels of testosterone than when they had a full night’s sleep.
When you are sleep deprived, it impacts levels of the stress hormone cortisol, which reduces testosterone just like stress can. A sleep-deprived state is a testosterone-deprived state. Everyone’s sleep needs are different, but it’s important that you wake up feeling refreshed.

Avoid Plastic Bottles
The controversial chemical bisphenol A (BPA) is found in many plastic water bottles as well as in the lining of food and beverage cans, and exposure to this plasticizer may result in low T. BPA can act like the female hormone estrogen in the body, which means it can lower levels of testosterone,
Don’t cook foods wrapped in plastic in the microwave, and try to drink from a glass or a steel thermos. The more flexible a plastic bottle, the more likely it is to leach BPA and affect the testosterone level

Think Zinc
If you take a multivitamin with zinc or eat oysters every day, your zinc levels are probably within the normal range. Aim for 12 to 15 milligrams a day to help stave off low T.

Some Fat Is Your Friend

Men who eat a low-fat diet have lower testosterone, because the body makes testosterone from cholesterol. But this doesn’t mean you should eat unhealthy bad fats. Instead choose healthy fats such as those found in avocado, nuts, and olive oil. These fats will boost testosterone naturally, but they won’t raise blood levels of artery-clogging cholesterol.

Skip the Sugar

Every time you eat sugar, testosterone is decreased, likely because the sugar causes a high insulin level which can decrease the testosterone level.
Bottom Line: Low testosterone levels are a treatable condition that affects millions of men. There are options that don’t require medication that also improve your overall health and wellness.

At Last: Viagra For Women

June 1, 2014

Drug makers are testing new drugs that may be able to increase sexual desire in women.
A drug to boost female sex drive could be worth billions to the first company that manages to get it approved by the FDA. Recently, two new treatments have made strides towards that goal. But some are skeptical of the real value of such a drug to the women it’s supposed to help.
In late 2004, FDA approval of Intrinsa, a testosterone patch for low female sex drive, seemed imminent. News reports heralded Intrinsa as a “Viagra for her,” suggesting that it would revolutionize sexual health for women just as erectile dysfunction pills had for men.

Except an FDA advisory panel saw things differently. Finding numerous problems with the evidence for the drug’s effectiveness and safety, experts on the panel voted against approving it. Procter & Gamble, the company responsible for Intrinsa, withdrew its application. Now the frontrunner in the race to market the first prescription drug for low female sex drive is Boehringher-Ingelheim Pharmaceuticals. It has a drug called flibanserin in phase III clinical trials, the final phase of drug testing required for FDA approval. The company is a WebMD sponsor.
Flibanserin is a bit mysterious. It is a kind of antidepressant, but it hasn’t been approved previously for any use. Boehringher-Ingelheim is saying little publicly about the drug. At the moment we are not sure how the drug works or what is the mechanism of action of flibanserin.
Another drug, called bremelanotide, is in development for low female sex drive and male erectile dysfunction. Both potential uses are being tested in clinical trials, which are early studies to assess how well a drug works and how safe it is.
Bremelanotide is a new chemical created in the laboratory. It’s given in the form of a nasal spray, and it acts on the central nervous system.
Bottom Line: Stay tuned as a pill for women suffering from sexual dysfunction may be just around the corner at a pharmacy near you.

Restoring The Fountain of Youth-DHEA Just May Be The Youth Hormone For Women

January 28, 2014

American women (men too) are always looking to find a way to turn back the biologic clock. We all would like to look like the women in Cosmopolitan and Vogue Magazines. If your goal is to look younger, feel better, and improve energy level, then you might consider the benefits of DHEA.

DHEA, dehydroepiandrosterone, is a hormone produced in the adrenal gland, the small triangular structure that sits on top of the kidneys. DHEA is made by the adrenal glands and is then converted to androgens, estrogens and other hormones. These are the hormones that regulate fat and mineral metabolism, sexual and reproductive function, and energy levels. DHEA levels increase until our mid to late 20′s then gradually decline. DHEA is a very powerful precursor to all of your major sex hormones: estrogen, progesterone, and testosterone. (Its molecular structure is closely related to testosterone). DHEA is called the “mother hormone” — the source that fuels the body’s metabolic pathway.

When DHEA levels are low, your body does not have enough working material for proper endocrine function. This throws off your hormone production and you feel a general sense of malaise, along with other symptoms of hormonal imbalance — how severe depends on how many other demands are being made on your body at the same time.
There is a growing body of evidence that healthy levels of DHEA may help stave off Alzheimer’s disease, cancer, osteoporosis, depression, heart disease and obesity, but there is still no clear-cut consensus. There may be some increased risks associated with DHEA for women with a history of breast cancer — all the more reason to take DHEA under medical supervision.

Symptoms of low DHEA include extreme fatigue, decrease in muscle mass, decrease in bone density, depression, aching joints, loss of libido, and lowered immunity.
DHEA is stated to be possibly effective for these conditions:
1. Aging Skin – Taking DHEA orally seems to increase epidermal thickness, sebum production, skin hydration, and decrease facial skin pigmentation in elderly men and women
2. Osteoporosis – Taking DHEA orally 50-100 mg per day seems to improve bone mineral density (BMD) in older women and men with osteoporosis or osteopenia.
3. DHEA is also thought to contribute to a sense of well-being when used by those with adrenal and/or androgen insufficiency.
4. It may also support lean body mass in postmenopausal women.

DHEA has many potential benefits but does also have some side effects, which include hair loss, hair growth on the face (in women), aggressiveness, irritability and increased levels of estrogen. Calcium channel blockers may increase DHEA levels and those using calcium channel blockers should avoid supplementation. Anyone with a history of hormone-related cancer such as estrogen sensitive breast cancer should definitely avoid DHEA due to the probability of increased estrogen levels.

If you don’t feel DHEA is appropriate for you, it may be possible to increase the body’s natural production of DHEA with regular exercise and restricting the number of calories you consume. Calorie restriction is associated with a longer life span and the increase in DHEA production may be partially responsible. In fact, there are many studies that show you can improve your DHEA levels naturally by maintaining a body mass index of 19-25, getting adequate rest and exposure to sunlight, exercising regularly (including sexual activity), and fostering more “downtime” in your life — but more on that in a moment.

Without a medical test it’s impossible to know what your DHEA levels are. Using blood tests, your doctor can check for estradiol in the follicular phase (usually days 3–9 of a menstrual cycle); progesterone in the luteal phase (days 14–28); DHEA-S; and both free and total testosterone levels.
Treatment With DHEA Supplements

If tests indicate the need for DHEA supplementation, you may start off with as little as 1-5 mg, twice a day. The dosage can be slowly increased to 10–12 mg per day. Most doctors do not suggest any woman exceed 25 mg per day if capsule forms are used. Once balance has been restored and symptoms even out, most women produce enough DHEA on their own.

Bottom Line: Many women are suffering from hormone imbalance. Decreased DHEA can be a cause of many problems affecting middle age women and can even impact her libido and her energy levels. DHEA should never be taken casually or unsupervised, but its benefits are real for the women who need it.

Libido In the Tank-Fill ‘Er Up With Maca

August 21, 2011

Maca, the Peruvian herb, has been generating lots of buzz about its reputed ability to boost libido.
It is revered in the ancient Incan culture for its many medicinal purposes. According to folk belief, it is a plant known for its legendary ability to deliver energy and mental clarity, and enhance sex drives in Peruvians for more than 2,000 years.
Maca is an herb that has plenty of anecdotal information passed down from generation to generation, but scientific evidence on its effectiveness is limited. Researchers continue to study how it may help men and women with low libido. Some studies suggest it may improve semen quality, relieve symptoms of menopause, and reduce enlarged prostates.
A review of maca in the journal Current Sexual Health Reports concluded “there is no strong medical evidence in support of its use for female sexual dysfunction.”
In Peru, maca has been a staple in the diet of men, women, children, infants, pregnant and lactating women, elderly, and the infirm — out of necessity. Only two crops grow in the higher elevations in Peru: potatoes and maca.
In the Andes, people typically eat about half a pound of maca daily. Maca (Ledpidium meyenil) is an Andean root, referred to as an herb. It’s a starchy tuber that resembles a radish or a turnip but tastes more like a potato.
Like other starches, maca contains carbohydrates, protein, fats, and dietary fiber. It is also rich in plant sterols and a good source of iron, magnesium, selenium, and calcium.
There have not been reports of adverse effects of eating maca, so it is probably safe.
Talk to your doctor before taking any supplements because even though maca is a natural product grown in the Peruvian highlands, there are always potential side effects, including those from processing.
A growing demand for maca has resulted in a wide variety of products online and in health food stores boasting sexual health and stamina-enhancing claims. Maca, like other dietary supplements, are not reviewed or approved by the FDA.
This article was excerpted from an article in WebMD by Kathleen Zelman, MPH, RD, director of nutrition for WebMD.

Hypoactive Sexual Desire- or I’ve Got a Headache!

April 25, 2010

He: “Are you in the mood?”

She: “Naw, I’ve got a headache!”

If you are a female and you experience these feelings about loss of desire for sexual intimacy, you may have hypoactive sexual desire (HSD).  In other words, you’re rarely in the mood; you neither initiate sex nor seek stimulation. Hypoactive sexual desire is the most common form of female sexual dissatisfaction and occurs when there is a persistent lack of desire or absence of sexual fantasies.

Lack of desire often occurs as a result of problems with your partner.  Communications problems, anger, a lack of trust, a lack of connection and a lack of intimacy can all adversely affect a woman’s sexual response and interest.  If this sounds like you, counseling and therapy with your partner is probably your No. 1 treatment option to overcome HSD.

In addition to psychological causes there are medical causes of HSD.
Many commonly prescribed drugs, such as antihypertensives, antidepressants and birth control pills, interfere with sex drive, arousal and orgasm by affecting the balance of sexual hormones and the transmission of chemical messengers. Antidepressants, known as selective serotonin reuptake inhibitors (SSRIs), combat depression by increasing the production of serotonin in the brain. Although serotonin may decrease depression, it also dampens sexual desire.

The onset of menopause, either surgically produced by removing the ovaries or naturally as a consequence of aging, is characterized by a gradual decline of the hormones estrogen, progesterone and testosterone. Reduced testosterone levels can lead to a decline in libido. Ironically, the conventional hormone replacement regime of estrogen given to relieve menopausal symptoms can make matters worse, because estrogen increases a protein (called steroid hormone-binding globulin) in the blood that binds to testosterone, causing testosterone to become less available to the body.

Depression is also associated with HSD. A common symptom of depression is diminished sex drive, which, in turn, can exacerbate depression. Studies indicate that 12 percent of all women will experience clinical depression at some point in their lives. One of the side effects of the popular antidepressants Prozac, Paxil and Zoloft is loss of libido. Even with a lower-grade form of depression that is not easily recognized because you can function with it. A woman with depression may feel isolated and overwhelmed and withdraw from sex and social activities.

Overcoming HSD
If you’re suffering from loss of libido and think there is a medical basis for your problem, here are some solutions to consider:

Talk to your doctor about testosterone, especially if you have had your ovaries removed, are taking estrogen or under severe stress. Get your testosterone level evaluated and if it is below 20 nanograms per deciliter, consider starting testosterone therapy. Testosterone is central to a woman’s sexual function that no amount of sexual stimulation can make up for its absence.  Using testosterone to treat FSD has not been approved by the FDA, so you’ll need to find a physician open to prescribing it to treat lack of sexual desire. If you are already on hormone replacement therapy for menopausal symptoms, ask your doctor to add testosterone to your regimen.

Switch to medications known to have less effect on sexual function or lower dosages. The antidepressants Prozac, Zoloft and Paxil, of which women are major consumers, cause loss of libido in as many as 60 percent of patients. I suggest asking your doctor to change to an antidepressant that has less sexual side effects like Celexa, Wellbutrin, BuSpar, Serzone or Effexor.

Viagra, the little blue pill used to treat erectile dysfunction in men, may help jump-start your sex life as long as you have the desire to engage in sex and have been stimulated enough for it to take effect,. It’s especially helpful if your lack of desire is related to hysterectomy or menopause. Doctors aren’t exactly sure how Viagra helps rekindle lust but it helps women achieve arousal, which is the phase that comes after desire, by increasing blood flow to the vagina, clitoris and labia.

For more information contact your physician or find a physician who has experience treating HSD.  I also recommend the best-selling book For Women Only by Jennifer and Laura Berman.

Sexual Problems in Men-Is it low libido or impotence

April 14, 2010

Nearly 30 million men suffer from erectile dysfunction (ED) or impotence and nearly half that number have a decrease in their sex drive or libido.  However, many men believe that erectile dysfunction and diminished libido are the same thing.  It is important that men understand the difference between ED and libido.  ED is the inability to achieve and maintain an erection adequate for sexual intimacy with a partner.  Loss of libido is a decrease in the interest for sexual intimacy.  ED and loss of libido can be separate issues or can occur together as it is common for a man who suffers from ED for a prolonged period of time will also experience a decrease in libido.

What are the symptoms of decrease in libido and what are the causes of this condition?   A decrease in libido is usually a result of a decrease in the level of testosterone which is a hormone produced in a man’s testicles.  A decrease in libido is the most common symptom of testosterone deficiency.  Men with a decrease in testosterone also experience a lack of energy and often complain of lethargy.  Men with decrease in testosterone also experience a decrease in strength or endurance, lose height, fall asleep after dinner, and may even experience depression or a decreased enjoyment in life.

Some causes of testosterone deficiency include:

Testes – medical problems that begin in the testes can prevent sufficient testosterone production. Some of these conditions are present from birth; for example Klinefelter’s syndrome, a genetic disorder that affects the sex chromosomes. Other conditions may occur at various stages of a boy or a man’s life; for example, undescended testicles, loss of testes due to trauma or ‘twisting off’ of the blood supply (torsion), complications following mumps, and the side effects of chemotherapy or radiotherapy.

Pituitary gland – the most common condition that affects the pituitary and leads to low testosterone levels is the presence of a benign tumour. The tumour may interfere with the function of the gland, or it may produce a hormone that stops the production of the gonadotrophins and stops the pituitary gland from signalling the testicles to produce testosterone.

Hypothalamus – particular conditions, such as tumours or congenital abnormalities, can prevent the hypothalamus from prompting the pituitary gland to release hormones. This will inhibit testosterone production by the testicles. This is a rare cause of androgen deficiency.

Drugs can also decrease libido. Many prescription antidepressants can diminish sex drive. Other medications with this side effect include tranquilizers and blood pressure medications. Illicit substances, such as heroin, cocaine, and marijuana, when used heavily and chronically, may lower libido and sexual performance.

Testosterone levels gradually decline after the age of 40. Some estimates suggest that up to one in five men over 70 years have low testosterone levels. A number of factors may contribute to the fall in testosterone, in addition to the ageing process itself. For example, any cause of poor general health, including obesity, will lower testosterone.

The diagnosis of low testosterone is made by a careful history and physical examination followed by a blood test that measures the testosterone level in the blood.

Treatment for proven androgen deficiency is based on hormone (testosterone) replacementtherapy. Testosterone can be administered by tablet, skin patch or gel, injection (short or long acting) or implant.  There is a long acting implant that consists of a pellet that is placed underneath the skin using a local anesthetic in the doctor’s office.  The pellet usually lasts for approximately 6 months and can be easily replaced using the same technique. Men who receive testosterone replacement therapy will require regular visits with their doctor. Prostate examinations are performed according to a man’s age and other risk factors for prostate cancer.

The benefits of testosterone replacement therapy include Increased sexual interest, restoration of erectile function, increased muscle mass, increased strength of bones, and improved mood and sense of well being.

Most sufferers of Low testosterone believe their symptoms are simply a function of growing older. As a consequence, they never seek the medical attention needed. Today, low testosterone treatment options exist that can relieve the symptoms of decreased testosterone and can help men reclaim their lives.

Bottom Line: Testosterone deficiency and the accompanying symptoms of decreased libido, lack of energy, and loss of muscle mass is a common condition that affects millions of American men.  The diagnosis can be easily confirmed with a blood test and the treatment using testosterone replacement therapy can be achieved with several treatment options.