Most believe sex should be a simple and innate desire; however, there are a number of factors that can interfere with this instinctual act. Libido, commonly known as an individual’s sexual desire or “sex drive,” is affected by a number of physiologic and psychologic elements. At True You Medical, we recognize the complexity, as well as the importance, of a healthy sex drive. You can trust that we will take a comprehensive approach – addressing multiple facets as we seek to restore the spark for you and your partner.
What is Hurting Your Libido?
Medication-Induced Side Effects
A number of medications have a side effect of reduced libido.The following are among the most common:
- SSRIS – Selective Serotonin Reuptake Inhibitors (Prozac, Zoloft, Celexa, Paxil) are the most commonly-prescribed antidepressants. These medications work to increase the levels of serotonin in the brain.Serotonin, commonly known as the “happy molecule,” has a profound ability to increase mood; unfortunately, elevated serotonin has been found to decrease libido and ability to orgasm.
- TCAS – Tricyclic Antidepressants (Tofranil, Palemor, Vivactil) alter your levels of serotonin and norepinephrine.These are less often prescribed nowadays due to their side effect profile, but also negatively affect libido due to similar mechanisms as SSRIs.
- Birth Control Pills are common offenders in squashing libido in women. Birth control pills decrease sex drive due to (1) suppressed ovulation; (2) anti-androgenic effects; and (3) increasing sex hormone-binding globuline (SHBG). During ovulation, women naturally have a higher sex drive. This instinctual hormonal spike creates a perfect combination for creating life. The last two points go together and involve the hormone testosterone – which is most responsible for libido in both men and women. Many birth controls have been shown to decrease levels of testosterone in women.Furthermore, when taking exogenous estrogen, SHBG increases.SHBG is a protein that binds sex hormones – including estrogen and testosterone. When bound, these hormones are not active in our bodies.Therefore, with the already decreased levels of testosterone, much of it is bound – rendering most of what is left inactive.
- 5 Alpha Reductase Inhibitors (Proscar, Propecia) are commonly-used drugs to treat enlarged prostate glands and male pattern baldness.These drugs work by blocking 5 Alpha Reductase – an enzyme responsible for converting testosterone to dihydrotestosterone (DHT). DHT is the most potent male hormone, contributing greatly to both the good and bad effects of androgens. While these drugs may reduce risk of prostate growth and hair loss, they may also decrease sex drive, energy, muscle mass and mood.
- Anti-seizure Drugs (Carbamezapine) work by dampening nerve impulses. Because this is a systemic effect, these drugs can decrease sensation during sexual intercourse – thereby making it less enjoyable.
- Opioids seem to dull libido by three main mechanisms: (1) decreasing levels of testosterone; (2) increasing prolactin; and (3) suppressing neural receptivity.
- Beta Blockers (Atenolol, Propranolol, Pindolol, Timolol) are anti-hypertensive drugs used to lower blood pressure by slowing the heart rate. With decreased blood flow, erectile dysfunction can be a side effect. Additionally, beta blockers have been shown to decrease levels of both total and free testosterone.
Just like all other aspects of health, the health of your libido often reflects the health of your lifestyle. Don’t ignore the following as potential offenders:
- Alcohol intake.
- Marijuana use.
- Poor diet.
- Lack of sleep.
- Lack of exercise.
Optimal libido requires optimal hormone balance – with cortisol, thyroid, estrogen and testosterone being the four most important factors.Cortisol, our “stress hormone,” can seriously impact sex drive. A number of lifestyle factors can affect cortisol, such as blood sugar fluctuations, anxiety and stress, overwork, lack of sleep and steroid medications. Low thyroid can make you feel lackluster in general – causing feelings of depression, fatigue, weight gain and low libido. Estrogen is tricky, as it must be “just right” – too high and too low estrogen can cause sex drive to suffer. Finally, testosterone is considered to be the king of all sex hormones, known for its powerful stimulation of sexual desire. However, like estrogen, this also must be in perfect balance. Too high of testosterone in women can also dampen libido.
Scientists are beginning to explore how our sex drive is influenced by our neurotransmitters. Most of what we know was originally discovered through side effects of medications. For instance, a common side effect of SSRIS is a low libido. We now know that high serotonin can decrease sexual desire. Furthermore, sexual desire and arousal is primarily mediated by the neurotransmitters dopamine and acetylcholine, respectively. Insufficient levels of either of these two could be the reason for a dull sex life.
Emotional barriers can be some of the most difficult culprits to address. We all know emotions contribute to a variety of health conditions – and libido is not immune to elements of the mind. If you are suffering from any of the following, it is possible that this may be a contributing factor.
- Critical Body Image
- Past Sexual Abuse