Drugs and Sexuality Flashcards
Two main ways that drug affects sex
- altering libido
- altering performance
What 3 things INCREASE libido?
TED
– testosterone (male & female)
– Dopamine
– Estrogen in females?
What three things decrease libido?
SEP
– prolactin (male & female)
– estrogen (male)
– serotonin
What’s the role CNS neurotransmitters in libido?
DAN increases
- dopamine
- NE
- ACh
What’s the role CNS neurotransmitters in libido?
SALLY decreases
- serotonin
What are the typical effects of drugs on sex?
DECREASE libido by
Hormonal:
– increasing prolactin secretion
– anti‐androgenic
CNS effects:
– block DAN, increase Sally
What would increase sexual response?
androgen receptor agonist (testosterone)
How could you interfere with orgasm?
alpha-1 blockade
antihypertensive drugs frequently cause sexual problems
α1 blockers: high incidence of ejaculatory failure (but not
of erection)
Which anti-HTN have few sexual side effects?
CCB, ACE, ARBs, DRIs
Psychiatric drugs:
A common source of sexual problems
But: the disease state itself often affects sexuality,
complicating analysis of drug effects
Antipsychotic problems
Decreased libido due to
– DA receptor blockade
– CNS anticholinergic effects
– CNS sedative effects
• Problems w/ erection due to peripheral ACh effects
• Problems w/ orgasm due to peripheral α1 blocka
What is the only antipsychotic drug that increases libido??
Levodopa: enhanced libido (increased DA)
What effects does acute alcohol ingestion have?
disinhibiting, less intense orgasm
What effect does chronic alcohol ingestion have?
Neuropathy
decreased testosterone
Acute Cocaine, Amphetamines and Sex
lower doses: enhanced libido (↑DA); delayed orgasm
Chronic Cocaine and Amphetamine use
loss of libido; depression
– ejaculatory failure
Marijuana and sex
– lower doses: enhancement of sensory effects;
disinhibition; increased empathy
– higher doses: impotence, anxiety
Treatment of
Premature Ejaculation
local anesthetic
various agents to delay orgasm have been tried . . . but many of the drugs inhibit libido.
Can testosterone be used to enhance libido?
Yes
– Libido response in both males and females
– Can accelerate prostrate cancer, atherosclerosis (?)
True/false: Dopamine agonists can be used to enhance libido.
true
The three P’s: smooth muscle relaxants to treat ED
- papverine
- phentolamine
- prostaglandin E
Papaverine
– for diagnosis and treatment
– quite effective, but limited by multiple adverse effects (bradycardia, hypotension,
priapism)
– chronic use associated w/ hepatotoxicity, penile fibrosis
Phentolamine
α1 blocker – blocks sympathetic smooth muscle contraction
– usually used as adjunct with papaverine
• But can interfere w/ orgasm
