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Are medications getting between you and your partner in bed?

7/9/2019

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Decreased libido is probably one of the most common complaints I get.  The conversation usually goes something like this- I have no desire to have sex- can you please check my hormones.   For women, hormones like estrogen, progesterone, and testosterone usually fluctuate based on the time of the cycle they are checked. Their value at different times in the cycle rarely gives us any insight as to the source of low libido. 

However, what most people forget is that the most common culprit for low libido is side effects from medications used to treat common maladies like hypertension and depression.  About 44% of Americans take at least 1 prescription medication and 17% take 3 or more.  If you look at a list of side effects for commonly prescribed medications, the list is so long that something like low libido can be easily overlooked.  Let’s go over some common medications that can affect your libido.
​
  1. Antidepressants: SSRI’s like Prozac and Zoloft just to name a few are very well known to decrease sexual desire and diminish or delay orgasm.  58 to 70% of people taking SSRI’s experience these kinds of sexual side effects.  Why does this happen? SSRI’s work to increase the amount of serotonin circulating in the brain.  While serotonin helps you feel less depressed, too much serotonin can decrease a person’s sex drive and make it harder to achieve orgasms.  Talk to your provider if you experience this.  There are other antidepressants that have less of an impact on sex drive, and depending on your medical history, these may be an option. 
  2. Birth Control Pills: Oral contraceptive pills, especially those with estrogen, can lower hormones like testosterone, and this can affect libido.  If you experience this, talk to your provider about other options like IUD’s. 
  3. Marijuana: While not always used in a medical application, just because it is legal in some states does not mean that there aren’t side effects.  Marijuana can have a significantly negative impact both on libido and even the ability to have intercourse.
  4. Opioids: Opioids can lower testosterone and have an adverse effect on sex drive. 
  5. Hypertension medication: Blood pressure medications help lower the pressure inside blood vessels, so the heart doesn’t have to work so hard.  This reduced flow can interfere with orgasms in women and erections and ejaculation in men.   Common hypertension medications like beta blockers and diuretics can help lower blood pressure but can also have a negative impact on your libido.
  6. Benzodiazepines: Xanax can help reduce anxiety, but it can also dampen your sex drive. The sedative and muscle relaxant properties are thought to lessen interest, excitement and sensation. Essentially, while making you numb to anxiety, it can also make you numb to arousal.
  7. Statins: Statins are used to treat patients with high cholesterol.  Cholesterol is one of the building blocks for testosterone.  Interfering with the production of sex hormones like testosterone can adversely affect sexual desire. 
  8. Antihistamines:  Benadryl and other allergy medications can dry out your runny nose, but they can also make you dry down there.
  9. H2 Blockers (Zantac, Tagamet, Pepcid), which are used to treat gastroesophageal reflux and ulcers, while not as much of an issue for women, can cause impotence as well as breast enlargement in men. 
 
This blog is actually the short version of the list of medications that can interfere with both desire and performance of intercourse.  There are many more medications that can adversely affect your sex drive.  If you are on one of these medications and have noticed an adverse effect on your libido, please talk to your provider before discontinuing the medication.  Weighing the benefits of the medication as it relates to your individual health as well as whether alternative treatment options are available is a conversation that you should have with your provider prior to making any changes in your medical regimen.  Good luck keeping that healthy desire burning!

Dr. Pam
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