Some important clues as to which groups of medicines affect the female and male libido
Many patients get prescribed medications that they do not take. A quarter of all prescriptions are not even filled. Dr Henry Rosevear, urologist, asks his patients why they don’t take their drugs and often gets the answer that taking them has a negative effect on their libido, i.e. they are real sexual turnoffs. This is a big problem for many patients, which all of you can understand.
However, it is often not known which medicines can influence sex life and even bring it to a standstill. That is why we want to give you an overview in this article.
In an article written for the medical portal Medscape, Dr Rosevear names six groups of drugs that have a negative influence on libido. Two more were added to his list by Dr Maria Gabriela Baumgarten Kuster Uyeda in another article.
Group 1 (women and men): Antihypertensives
Men can only get and maintain an erection if the penis is supplied with enough blood. But the antihypertensives, especially the beta-blockers, are designed to prevent just that. For women, too, reduced blood pressure can have a negative effect on their sexuality.
Group 2 (men): Alpha-blockers to prevent enlargement of the prostate gland
The first generation blockers (terazosin and prazosin,…) also lower blood pressure and have the same effect on the penis (also called erectile dysfunction) as the beta blockers.
The second generation blockers (tamsulosin or silodosin, …) prevent ejaculation to the outside. Sperm is sometimes directed into the bladder instead. This is very strange for some men, because for them orgasm also includes ejaculation.
Group 3 (women and men): Serotonin reuptake inhibitors (SSRI) for depression
Serotonin is known as the happiness hormone and too little can have a negative effect on our mind. Medicine has developed so-called antidepressants, especially for depression, but also for obsessive-compulsive disorder, panic attacks and other anxiety disorders. One group of drugs is the serotonin reuptake inhibitors (fluoxetine, paroxetine, sertraline, citalopram and escitalopram). They cause prevention of orgasm (in both sexes) and also ejaculation.
Group 4 (men and women): Other antidepressants
In addition to SSRIs, there are three other groups of drugs for depression that also affect the libido. Conversely libido dips can further fuel the cycle of depressive moods.
- Tricyclic antidepressants (amitriptyline, doxepin, imipramine, nortriptyline)
- Monoamine oxidase (MAO) inhibitors (phenelzine, tranylcypromine)
- Antipsychotic drugs (thioridazine, thiothixene, haloperidol)
In case of loss of libido, the use of 5-phospho-di-esterase (PDE) inhibitors (sildenenafil and others) may be considered instead of the other drugs in both sexes, in consultation with the attending physician, if orgasm is delayed and there are no contraindications.
Group 5 (men): cancer drugs for prostate cancer
All the drugs used today lower the testosterone level very strongly and thus reduce the libido. In other words, you can no longer get horny. However, it is certainly difficult for every cancer patient to have sex after diagnosis, because the psychological strain is extremely high in many cases.
Group 6 (men): Phosphodiesterase-5 inhibitors (PDE5 inhibitors)
PDE5 inhibitors (sildenafil, tadalafil, vardenafil and avanafil) were originally developed to treat angina pectoris and high blood pressure. They can dilate the blood vessels (so-called vasodilators). Over time, it has been recognised that they are able to induce erections. Huh? That’s the exact opposite, they actually help to induce erections.
Yes, but they also have side effects that you should be aware of, namely headaches, a blocked nose, facial flushing and heartburn, and can thus lead to listlessness. But you can do something about it: don’t eat anything before taking these substances, avoid alcohol, drink enough, fighting the side effects with over-the-counter medicines like paracetamol or ibuprofen can help.
Group 7 (men and women): Antipsychotics or neuroleptics (dopamine inhibitors)
These drugs are used in particular to treat schizophrenia. The inhibition of dopamine negatively affects sexual function and can also lead to vaginal desiccation. It is suggested to switch to antipsychotics of the newer generation (atypical neuroleptics) (clozapine, olanzapine, quetiapine, zotepine, benzamide derivatives: sulpiride, amisulpride, risperidone (active metabolite paliperidone), ziprasidone, aripiprazole). But beware: these also bring considerable side effects.
Group 8 (women): hormonal contraceptives
Birth control pills reduce a woman’s testosterone levels. And oestrogen can increase SHGB (sex hormone binding globulin) levels, leading to lower levels of free testosterone in the blood. A low testosterone level can, but does not have to, lead to a decrease in libido.
Basically, we want to add that libido also has a lot to do with the head. In any case, you should check whether your problem is more on the psychological level (which is often the case). If so, the cause should be found there and not in the wrong medication. If you are still convinced that your medication is a real sex killer for your love life, seek professional help.
Important note
Do not change your medication without consulting your doctor!