Drugs and Sex Flashcards
(32 cards)
General mechanisms for drugs to affect sexuality
Libido and performance
Hormones and NT’s that increase libido
Testosterone
Dopamine
Estrogen (female), FSH, LH?
Hormones and NT’s that decrease libido
Prolactin
Estrogen (male)
Serotonin
Hormonal effects of drugs on sex
Increased prolactin secretion
Anti adrenergic
CNS effects of drugs on sex
Block dopamine, NE, Ach, enhance 5HT, sedation
Interference with erection mechanism
Peripheral anti muscarinic action
Decreased blood flow
Interference with orgasm mechanism
Alpha 1 blockade
Anesthetic
Sedation
Antihypertensives that cause sexual problems
Ganglionic blockers Clonidine Methyldopa Alpha 1 blockers Beta Blockers - 5-10% Spironolactone Thiazide diuretics
Antihypertensives with few sexual side effects
Calcium channel blockers, ACE inhibitors, ARB’s,
Why are psychiatric drug effects on sexuality more complicated?
Because the disease itself can have effects on sexuality
Antipsychotics and libido
Decrease
DA receptor blockade
Anticholinergic
Sedative
Antipsychotics and erection
Decreased due to anticholinergic effects
Antipsychotics and orgasm
Decrease due to alpha 1 blockade.
Alcohol and sex - acute effects
Small doses - disinhibiting.
Large doses - impotence, delayed, inhibited, and/or less intense orgasm.
Alcohol and sex - chronic effects
Neuropathy - impotence
Decreased testosterone - lower libido.
Marijuana and sex - acute effects
Low dose - enhanced sensation,
High dose - impotence
Marijuana and sex - “Chronic” effects
Infertility, decreased testosterone, impotence, menstrual and ovulation problems.
Cocaine, amphetamines acute effects
Low dose - enhanced libido, delayed orgasm. High dose direct stimulation of erection.
Cocaine, amphetamines - chronic effects
Loss of libido, depression, ejaculatory failure
Treatment of premature ejaculation
Local anesthetics, orgasm-delaying agents, The problem is that many of these also inhibit libido.
Treatment of low libido
Testosterone (low dose in females)
Dopamine agonists
Smooth muscle relaxants to treat Erectile Dysfunction
Papaverine - multiple adverse effects including penile fibrosis
Phentolamine - can interfere with orgasm
Prostaglandin E
Injectible and Urethral suppository
PDE5 inhibitors
Sildenafil (Viagra) - works on erection, NOT libido.
New drugs differ only in pharmacokinetics
PDE5 inhibitors mechanism
Inhibits phosphodiesterase 5, which degrades cGMP in the corpus cavernosum. In the presence of sexual stimulation, which causes a release of NO, this causes vasodilation and erection.
