Drugs and Sexual Dysfunction
Many drugs can affect sexual function in both men and women.1 In men the effects can lead to decreased libido, impotence, sluggish or absent orgasms, and non-ejaculation. In women, the effects are less severe, but include loss of libido, sexual repression, and lack of orgasm. Unfortunately, many patients believe that the decline in sexual function is due to age. In fact, the problem comes from medication (prescription drugs).2 Sexual function often changes when a drug that is not working well is stopped or changed. Physicians should be unapologetic about talking to their patients about this. The issue of drug-induced sexuality is now receiving widespread attention.
Antihypertensives and vasodilators
Diuretics are often used as the drug of choice in the treatment of hypertension. About 1/3 of those taking diuretics (hydrochlorothiazide, chlorthalidone, benzoflumethiazide) have libido, erectile and ejaculatory disorders, but the cause is not known. Spiropropionate (ambrisentin) is a drug that can cause changes in sexual function in some men. High doses have antagonized male androgen receptors and decreased libido, leading to impotence and gynecomastia.4 Digoxin, a cardiotonic agent, has a similar structure to sex steroids, increasing estrogen production and decreasing androgen production, leading to impotence and gynecomastia.5 Methyldopa (Aldomet), a chemical compound involved in neurotransmission can similarly cause erectile problems. Both guanethidine and clonidine antagonize the neurotransmission pathway and can therefore also cause impotence. clonidine is an alpha 2 competitor that can affect erectile function and over 40% of patients have a decreased libido. Second-line blockers are also abused because hypertension causes many cardiovascular problems. Men taking beta-blockers, one of the most common beta-blockers, also complain of poor erections and decreased libido (Table 1). When a beta blocker causes problems, a different type of drug immediately replaces it. Reducing the pressure of perfusion during antihypertensive therapy may primarily lead to reduced penile erections.
Vasodilators, which help dilate arteries and increase arterial patency, appear to be helpful for erections, but hydrazinizine and some calcium channel blockers have significantly affected erections or can increase abnormal erections.3 Only anti-hypertensive drugs such as angiotensinase (ACE), inhibitors, nifedipine (a calcium channel blocker) and a hair regenerator have no complaints of sexual dysfunction. In fact, they can improve blood supply to the spongiosum of the penis and improve erectile function in men after a longer period of use.
Psychotropic medications
Most psychotropic drugs are often used as anti-stress medications.3 They include ascending and descending agents, sedatives, analgesics, stimulants, anxiolytics, antidepressants, and tranquilizers. Many of these drugs affect neurotransmitters that pass through receptors to another receptor. Therefore these drugs are considered to function as blockers or reuptake as they do. They include Valium,Librium,tricyclic anti-stress drugs, Tofranil,amitriptyline,clomipramine, MAisocarboxazid,Nardil,Parnate, etc.
Depression and related drugs
Depression can lead to loss of sexual desire and sexual dissatisfaction. Antidepressants, such as serotonin
reuptake inhibitors/clomipramine, lithium carbonate, and monoamine oxidase mimetics cause more impotence, ejaculation, and erectile difficulties than other types of antidepressants6,7 , resulting in sexual arousal, stimulation, and erection being significantly affected by these drugs. A new antidepressant, Prozne, is a drug that has selective (serotonin
reuptake inhibitors) adversely affects men, but was found to be used for premature ejaculation.
Other drugs that can cause impotence with long-term use are: Antabuse, Ketoconazole, Indocin, Amicar, Dilantin, Antrocol, arcolase, Butabell, Diamox, Sansert, Flagy1, Satiric, Flexeril, Norflex,Norflex,Akineton,Estrace,Trecator-SC etc.
Environment and impotence
Environment plays an important role in sexual life. Divorce, death of a relative, depression, worries, stress, etc. can cause medical and psychiatric disorders, which can also cause sexual dysfunction as well.
Physical risk factors
Not long ago, impotence was thought to be caused by a mental factor. Now, however, diseases of the body’s organs are also considered to be one of the most common causes. People with physical ailments are more likely to suffer from impotence than normal people. According to the Massachusetts Male Study, the causes of impotence are cardiovascular disease, hypertension, diabetes, chronic ulcers, arthritis, and allergic reactive diseases. It is difficult to decide whether the physical condition is the most important risk factor or its cause, or a combination of both factors. Smoking is also a risk factor.
Cardiovascular system diseases and hypertension
Any condition involving blood flow, such as obstruction of arterial blood flow, sclerosis and narrowing or thickening of blood vessel walls, can lead to disease. Coronary artery bypass surgery in men or due to myocardial infarction, pulse pulsation, or vascular disease can affect arterial blood supply causing impotence. Pelvic radiation therapy also causes small arteries to lose capacity and dilate. Men with hypertension are more likely to have impotence than other men because medication for hypertension has an effect on impotence.
Diabetes
MMAS results show that diabetics are three times more likely to suffer from impotence than non-diabetics, including those with type I and II diabetes who have an earlier age of onset than other men. It often occurs within 10 years of a clear diagnosis. Diabetes is often associated with apprehension, hypertension, obesity and neurological factors, but why diabetes has poorer sexual function is not well understood and may be due to pathological changes in veins, nerves and microvasculature.
Ulcers, arthritis and allergic diseases
In MMAS, impotence occurs twice as often in men with untreated ulcers, and medications for ulcers often cause impotence due to continued treatment. Similarly arthritis also causes impotence, and men who smoke have several times more impotence than non-smokers. In addition, allergic diseases are more likely to cause impotence than other men, and their anti-histamines treatment can cause erection problems.
Some other diseases also cause impotence, such as Peyronies disease, prostate surgery, radiation therapy, OSAS, abnormal penile erection, Parkinson’s disease, pathological nip bone protrusion, pelvic trauma, chronic pain complications, and functional disorders.
Pelvic Trauma
Many Americans suffer from impotence due to pelvic trauma caused by physical trauma or traffic accidents. According to recent reports, about 100,000 pelvic trauma impotencies with erectile difficulties are caused by bicycling or straddling injuries, but this opinion is not fully accepted. Half of the force sustained from cycling is in the internal pelvis of the body and the other half is offset by the seat of the bicycle. The pressure on the pelvis when a person travels 7.5 miles per hour is 1/4 ton, so cycling puts the arteries at risk for inadequate blood supply to the pelvis.
Physiological risk factors
Systemic organs that cause erectile dysfunction are a common, complex and irreversible problem. There are four physiological aspects that interact and influence male sexual activity, namely the cardiovascular system, the nervous system, the smooth muscle system and the endocrine system.
The cardiovascular system
In the normal aging process of healthy individuals, the circulation of blocked organs increases by 1% per year after the age of 40, and despite some variations, diseases can have a faster rate or amplify these normal changes. From MMAS data it is reflected that HDL levels in the blood of men aged 40-55 years from 30 to 90 mg/ml can lead to a decrease in the incidence of impotence. 56-70 years, no one with HDL levels >90 mg/ml develops impotence. Thus HDL levels decreased and the incidence of impotence increased. All data show that HDL level is a determinant of impotence.
Neurological disorders
Nerve block extends the conduction of information in the nervous system. With age and decreasing neuronal conduction levels, the sense of touch can disappear. Many of the most common neurological disorders accompanying impotence are pinpoint injury, double cell sclerosis, and peripheral neuropathy. Because alcohol and diabetes and bladder cancer can affect the nerves in the pubic area causing impotence. Drugs and health medications can also cause nerve damage leading to neurological and psychological disorders.
Smooth muscle and endocrine system
With age, tension in the body is replaced, which can affect the structure of the smooth muscles of the penis. Although these changes do not show a correlation between obesity and impotence, excessive obesity is fat deposits in the walls of the arteries, making arteriosclerosis often lead to impotence.
Hormone levels
Male hormones can often influence sexual desire and behavior, but their role in erectile tissue is uncertain. Their deficiency leads to loss of sexual desire more than the effect on their erectile dysfunction. More notably, castrated androgen-free men can also have erections, possibly because of the presence of non-male dependent pathways. Researchers currently do not have the ability to identify the relationship between testosterone and target organs in the 17 sex hormones tested in the MMAS, with only DHEAS found to be primarily associated with impotence. This hormone is secreted by the adrenal glands and gradually decreases and accelerates with age. High levels of prolactin similarly reduce libido and increase impotence. Hypothyroidism in men may be important, and men with hypothyroidism are more likely to lose their sexual desire, leading to impotence. The effect of testosterone on libido and sexual function is uncertain unless a clear deficiency exists.
Is there a male menopause with altered sex when testosterone begins to decline in men in their 40s and early 50s, which naturally brings about some physical problems? Is there or not? If there is a male menopause, can testosterone treatment cure these symptoms? However, the answer to the question of whether male menopause exists is no, because men differ from women in having a sudden and significant drop in hormone levels. If there is. It is because many men have a gradual decline in testosterone and men do not have the physiological changes caused by hormonal changes that women have, but that does not mean that they do not have the changes that may exist. Physiological age changes, it is not in as young as the energy can quickly recover. As in six months ago, male hormone levels begin to decline and low hormone levels can often lead to loss of libido. In hypogonadal men testosterone replacement therapy results in improved libido and self-confidence, but not sexual function.
Psychological or emotional risk factors
More than 80% of patients with chronic impotence have a biological aging process and at least 1 or 2 psychological causes. The remaining 20% do not know if there is a physical or pathological etiology. However even if the etiology is exclusively psychological or emotional, it is expressed in physiological terms that some information is not transmitted along the nerves or that a specific hormone is missing in the blood serum. Psychologists classify sexual dysfunction into sexual desire disorder, sexual erection disorder, orgasm disorder, intercourse anxiety or mixed disorders.
With age, many men often have a process of losing interest in sex, which is often a physical or psychological factor for a man to have impotence.
Anger
Anger is often associated with illness, divorce, sudden death, stress, overwork, conflict with peers, and depression. Excessive anger can lead to heart and blood vessel problems, cause excessive nerve tension and affect the relaxation of smooth muscles, therefore leading to psychological impotence.
Depression
The TMAS Center for Epidemiological Studies classifies depression as mild, moderate or severe. It was found that 90% of patients with severe depression had moderate or severe impotence. 59% of those with moderate depression and 25% of those with mild depression had erectile dysfunction. Also antidepressant drugs can cause impotence.
Dominance and other emotional conditions
Dominance is a fundamental characteristic of a person. Men attempt to control their environment and influence them. In MMAS, dominant men are more likely to prevent impotence problems, and other studies have shown that personal experiences or conditions can affect men’s erectile problems. Behavioral anxiety, distress, persistent worry about a problem, relationship conflict, sexual repression, excessive sexual activity, sexual aggression, and fear of pregnancy or STDs are all secondary factors in the development of impotence in some men. When these factors are predominant, it is the main reason for the occurrence of impotence and subsequently affects fertility.NIH factors in impotence consider loss of confidence, poor self-awareness and increased anxiety or sexual partner conflict as a specific factor causing sexual dysfunction as well.
Chemical exposure and impotence
The sexual process is fraught with chemical problems. Some chemical substances can act against testosterone, and the secretion of some of these substances by men will lead to a reduction in sexual desire and diminished interest in the ability to produce an erection. Some chemicals are sometimes used to treat sexual offenses. There are also other chemical and recreational agents that are used to increase sexual desire and potential that has not been scientifically tested.
Stimulants
Marijuana
According to national surveillance results, marijuana is abused, with an average of about 10 million Americans (from age 12 to old age) smoking marijuana each month. Cannabinoids found in marijuana are psychoactive, chemical factors, THC and other cannabinoids that are stored in body fat and accumulate over time, leading to long-term effects that reduce fertility and sexual function in regular users. Marijuana can also reduce blood testosterone levels, and the National Institute of Drug Disorders reports new sexual performance through the latest techniques of culturing and incubating plants that are 30 years old, and the dangers caused by these drugs are still not well understood, but are believed to be inevitable.
Smoking
Smoking paper cigarettes does not directly cause impotence, the chemicals in tobacco and its metabolites cause constriction of the arteries, and impotence occurs almost three times more often in men with heart disease smokers than in non-smokers. Similarly, male hypertensive smokers are twice as likely to develop impotence as nonsmokers
Alcohol
is a major contributor, alcohol often leads to changes in sexual behavior, alcohol increases sexual desire, arousal and euphoria and also has some minor pathological changes. In the interrelationship between alcohol and risky sexual behavior, large amounts of alcohol can lead to an increase in sexual dysfunction, a common claim is that alcohol provokes desire and, conversely, many men have difficulty completing or maintaining an erection after large amounts of alcohol, taking large amounts of ethanol makes it almost impossible to maintain an erection in the nerves. High estrogen and low testosterone are often found in men with alcoholic sclerosis.
Tension medications
Heroin, morphine, codone hydrochloride, cocaine, LSD, marijuana, amphetamines, and barbiturates have been widely recognized as affecting normal male sexual function, however, small doses are taken by some men as an aphrodisiac, acting as a comforting agent through their own behavior.
Industrial agents
Heavy metals: lead, arsenic, thallium, mercury, antimony and gold are thought to cause impotence and are toxic when ingested or otherwise entered into the body. Although they may interrupt hormones and cause impotence, the actual mechanism is unclear.
Organic compounds: Certain organic chemicals and solvents are considered risk factors for erectile function effects, N-2 alkanes, Rcrylamide, etc. should be used with general caution. Endocrine blocking chemicals, organic compounds have been studied in animals for their toxic effects on reproduction, such as Polychlorinate biphenyl, DDT, digoxin and some pesticides. These chemicals are often found in the environment and can interrupt normal endocrine function, it has been suggested that they resemble physiological hormones that interrupt endocrine secretion and when these substances are ingested, even small doses can interrupt body function. There is credible evidence that exposure to these chemicals has estrogenic behavior that reduces male levels or affects male mobility during development and can lead to erectile dysfunction. In recent observations of male offspring, exposure to DES can alter neurological function, including its development and maturation in the sexual organs.
Sexual stimulants
Nowadays, there are no drugs that can claim to help control hormonal imbalances and act as markers of sexual potency, which are considered useful for improving the body and preventing diseases. Garlic, ginseng and gingko agents are some of the most commonly used. Although there are some studies that consider their effects, scientific information based on environmental control is still lacking.
Plants
Ginseng is a traditional Chinese medicine and widhania sommifera is an Indian ayurvedis employed to increase energy and capacity, deal with fatigue and physical stress, and improve sexual function. However, the effects of these drugs are not yet clear and several recent studies speculate that the anti-carbon monoxide and organ-protective effects of ginseng are used to increase carbon monoxide in the endothelial cell layers of the lungs, heart and kidneys. Increasing the carbon monoxide system is helpful for ginseng VAS- or its roots have aphrodisiac effects. Future scientific studies are needed to confirm these.
Phytoproducts
A plant found in the tropics that has recently been suggested to have a sexual arousal-inducing effect on men. Long-term data using Indian tropical substances have been shown to have a supportive effect on male sexual function and desire, and it includes several roots of the plant that, when combined together, can increase blood testosterone levels by more than 10 times. Other natural sources thought to increase male sexual function are concentrates of muimpunare, also known as the wood of energy. Although not confirmed and supported by recent clinical trails in Paris, France, Phytoproducts come from nature in many fruits and vegetables, and have higher concentrations in the bark of pine trees and grape seeds, as known Phytoproducts are the most potent antioxidants for men, 50 times more than vitamin E and 20 times more than vitamin C. They are widely believed to increase the immune system, they help fight radiation, support collage, and are opposed by conservationists because their associations in a healthy body maintain that they play an important role in human sexual activity.
Jatoba tea is unique in the Amazon. Drank for centuries by different tribes in the Amazon to make them feel strong and energetic, they are widely used to treat and recover from fatigue and as a tonic for the respiratory and urinary system against bacteria and nitromycetes, and its products are used to increase libido and sexual performance.
Antioxidants
A good environment is extremely important because oxygen and other nutrients keep cells normal and avoid aging. Generally poor circulation including fatigue and decreased libido, poor food, radiation, drugs and chemicals are some of the factors that affect circulation. Vitamins A, C and E are natural nutrients that use antioxidants, immune stimulants and healing microcirculatory cleansers. Vitamin E is the most important antioxidant of the vitamins because it scavenges radioactive material and increases energy, stamina, energizes the body, prevents oxidation of cells and works better in combination with vitamin C in selectively impotent people, especially in diabetics.
Perfumes
Some perfumes related to sex and affect sexual behavior through the rich olfactory organs of humans, even found in embarrassing thoughts. Males are involved in influencing more variations than lower mammals because humans have a large number of visual systems, auditory systems. In most people these are certain. But psychopaths change psychologically (muskone, musk, castoreum and chemical synthetics such as exaltokick) these similar steroids can be observed frequently, such as the paint of wild boars and the pituitary gland in some antlers, and probably also about the perfumes (steroids) of muskiness used by some males, the role of carbonic acid in 6, 8, 10 is not clear. The fixed perfume has a similar function to the recording.
New perspectives in sexuality.
What are the reasons why men look for centuries to remain undiminished? Perhaps through the investigation of a drug is certain. The FDA recently deemed “Viagra” to be the most compliant. For men subject to much publicity, there is a particular attraction in sexually active and obsessed young men, who have exceeded the normal response to age-related changes such as hair loss. Sexual clinicians have now noticed many young men complaining of sexual problems. Loneliness has overtaken impotence, and they need to be aware of the physical and psychological changes that occur in both middle and older age. At the disposal of male nonopsusal complications can make a man feel out of control. Loss of work or loss of promotion in midlife, such as loss of self-esteem and lower desire for dominance in the same conditions, and a decrease in testosterone, make a man’s sexual desire to frustration. However, this cause may not necessarily lead to impotence, but over-expectation of sexual performance, as men face greater difficulties for their sexual requirements than being cured by any stamina (or unexplainable). These new erectile drugs will be unquestionably worthy of reference.
Conclusion.
Until the physiology about erectile construction was fully understood, many experts believed that erectile problems were mainly due to psychological causes. Today other causes are more likely to cause impotence. For example, pelvic injuries and prostate removal have been reported to damage the arteries and nerves that control the smooth muscle of the corpus cavernosum, as in the case of diabetes, alcoholism, and sclerosis. Even if the erectile nerves are not affected, psychiatric, hypertensive and other prescription medications can block the transmission of stimuli. The most common clinical cause of impotence, however, is atherosclerosis, where the ducts are blocked, leading to cardiac morbidity and compromise. The main risk factors for heart disease are smoking, poor diet, and lack of long-term exercise can all contribute to impotence problems. However the updating of knowledge and the emergence of new drugs, new treatments of formation are still in the preliminary stages. In other respects, because young and old, normal and impotent people also have conflicts with their medications, perhaps it may be caused by the abuse of certain drugs during treatment.