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At least 19 recordsLinked to original sources
PubMed1993

Disorders of sexual desire: diagnosis and treatment of decreased libido.

Decreased libido is the most common concern expressed by patients when they discuss sexual issues with their physicians. The causes of decreased libido are complex and multifactorial, requiring attention and a careful history to isolate the primary origin. Although dissatisfaction with the relationship or marriage is the most common factor in patients with depressed desire, organic causes must also be considered. Physicians must remember that depressed libido is relative and depends on the patient's definition, not on an absolute standard of how frequently people do or should have sexual relations.

Female↗
PubMedDate not supplied

Decreased testosterone in regularly menstruating women with decreased libido: a clinical observation.

Much more information is available concerning decreased libido in postmenopausal than in premenopausal women. Even less is known about androgen deficiency in younger women. We measured total and free testosterone levels in 12 consecutive premenopausal women complaining of decreased libido. Of the 12 women, 8 had low or immeasurable levels of testosterone despite having regular menstrual periods. Androgen precursor hormones, DHEA-S and Androstenedione, were low-normal to high-normal. Treatment with oral DHEA, 50 to 100 mg per day, restored sexual desire in 6 of the 8 women, gave partial improvement in one, and failed in another. Possible significance and etiological mechanism are discussed.

Administration, Oral↗
PubMed2000

Decreased libido in postmenopausal women.

As baby boomers age, the health issues of postmenopausal women have gained increasing media attention. Sexual well-being is an important health component for these women. The estimated rate of female sexual dysfunction in the United States is an astounding 25% to 63% with the most prevalent age group being postmenopausal women. Decreased libido is a major complaint of postmenopausal women, and many seek medical consultation for this problem. Unfortunately, current female sexuality research for this population is clearly deficient. Additionally, medical providers tasked with managing postmenopausal sexual dysfunction often lack training, experience, and the confidence necessary to handle sexuality concerns. Nurse practitioners, as superior counselors, are in a prime role to address this issue. The purpose of this report is to focus on the multifaceted problem of decreased libido in postmenopausal women, with management strategies to assist practitioners in managing and addressing this problem in the clinical setting. The report will investigate several physical, hormonal, and psychosocial factors impacting decreased libido in these women. Current and past research into this area will be analyzed to better define the current professional consensus on managing decreased libido in postmenopausal women.

Aged↗
PubMed1979

Decreased libido--a side effect of carbonic anhydrase inhibitor.

Thirty-nine cases of decreased libido in glaucoma patients on carbonic anhydrase inhibitors are reported. This symptom completely reversed or markedly improved after discontinuation of the drug in all cases. Twelve of these patients restarted their carbonic anhydrase inhibitor medication which resulted in a recurrence of decreased libido symptoms. There were 3 cases of impotency which reversed after discontinuation of the drug. Most likely, these symptoms are a result of the malaise and depression occurring in some patients on carbonic anhydrase inhibitor therapy.

Adult↗
PubMed2000

[A 24-year-old patient with decreased libido and erectile dysfunction as initial manifestations of hemochromatosis].

HISTORY AND CLINICAL FINDINGS: A 24 year old yugoslavian father of two children, complained of decreased libido and impotence since seven months. He also described recurrent joint pains in the knees and wrist joints. The urological and internal examination was unremarkable. INVESTIGATIONS: Except for slightly elevated liver enzymes and a mild thrombocytopenia the laboratory tests were normal. Testosteron, follicle stimulating hormone and luteinizing hormone concentrations were markedly decreased. Hepatosplenomegaly was demonstrated by ultrasound. TREATMENT AND COURSE: During testosteron administration for hypogonadotrophic hypogonadism erectile dysfunction improved. 9 months later the patient became diabetic and was referred to our department. Hemochromatosis was confirmed by serum ferritin concentration of 4010 micrograms/l, transferrin saturation of 85% and hepatic iron concentration of 27,900 micrograms/g dry weight. Molecular genetics showed no mutation of the hemochromatosis gene HFE. After venesection the ferritin concentration decreased, the loss of libido and subfertility improved with testosterone administration. CONCLUSION: In subfertility from an endocrine disorder primary hemochromatosis should be considered in the differential diagnosis. Only early diagnosis and prompt iron depletion may improve the prognosis of these patients.

Adult↗
PubMedDate not supplied

Characterizing female bipolar alcoholic patients presenting for initial evaluation.

This study examined gender differences of age and race-matched group of bipolar disorder (BPO) patients with comorbid alcohol dependence (AD; n = 65; males = 35, females = 30) to a group of BPO patients without comorbid AD (n = 61; males = 22, females = 39). The two groups were also similar on marital status and frequency of BPO subtypes. The results revealed that female bipolar alcoholic patients were more likely to report depressive symptoms as compared to either male bipolar alcoholics or both male and female non-alcoholic bipolar patients. When compared to male bipolar alcoholics, they had higher frequency of depressed mood, slow motor behavior, low self-esteem, decreased libido, decreased appetite, and higher general anxiety symptoms. On the other hand, female bipolar alcoholics differed from female non-alcoholic bipolar patients on reports of mood lability, depressed mood, low self-esteem, suicidal indicators, decreased libido, and general anxiety symptoms. These results raise the question of whether alcohol increases the frequency of depressive symptoms among female bipolar patients.

Adult↗
PubMed1984

Sexual dysfunction in multiple sclerosis.

A questionnaire study on sexual problems occurring with multiple sclerosis (MS) was carried out with 217 patients who had previously participated in the University of Washington Multiple Sclerosis Project. More than one-half of the participating subjects were ambulatory without aids and nearly 75% did not use a wheelchair. Sexual dysfunction was reported by 56% of the women and 75% of the men. Among the women, the most commonly occurring sexual symptoms (in decreasing order of frequency) were fatigue, decreased sensation, decreased libido, decreased frequency or loss of orgasm and difficulty with arousal. Men reported the most common problem was erectile dysfunction, followed by decreased sensation, fatigue, decreased libido, and orgasmic dysfunction. Although loss of mobility, weakness and depression are not significantly associated with sexual dysfunction, spasticity and bladder dysfunction appear to be associated. However, even where these symptoms were absent, sexual dysfunction was perceived in at least 50% of the cases. The data indicate that sexual dysfunction can be anticipated in at least 50% of the women and about 75% of the men affected by MS, regardless of mobility level. It is most likely to occur in patients with spasticity and bladder dysfunction.

Adult↗
PubMed1988

[Sexual disorders in women with slowly progressing schizophrenia].

The article deals with sexual disorders in the form of lack of libido, decreased libido, anorgasmy, decreased orgasmic response, loss of the emotional element of libido, predominance of the rational element of sexual libido, manifestations of pseudovaginismus and unmotivated revulsion toward sexual intercourse in women (aged 20-47 years) with slowly progressive schizophrenia and a 2-15 year history of the endogenic process. Definite correlations between psychopathological and sexual pathological manifestations have been ascertained. Sexual disorders were of a secondary systemic nature and were undetected if the endogenic process began after the completion of all stages of normal psychosexual development.

Adult↗
PubMedDate not supplied

Goserelin acetate implant: a depot luteinizing hormone-releasing hormone analog for advanced prostate cancer.

Goserelin acetate implant is a newly approved depot formulation of a luteinizing hormone-releasing hormone (LHRH) agonist indicated for palliation of advanced prostate cancer. LHRH superagonists suppress gonadotropin release from the pituitary gland by causing down-regulation of receptors. The sustained-release dosage form contains goserelin acetate dispersed in a biodegradable copolymer matrix and is designed to release active drug over 28 days. Pharmacokinetic studies have demonstrated that, despite nonzero order release of goserelin from the matrix, goserelin acetate implant maintains serum concentrations of testosterone in the range normally found in castrated men (less than 2 nmol/L) throughout the recommended 28-day dosing interval. Response rates similar to those for orchiectomy and estrogen administration have been demonstrated. Combination therapy with either diethylstilbestrol or flutamide has produced favorable results, although the major advantage appears to be a reduction in the tumor flare seen during the first week of LHRH agonist therapy rather than an increase in response rate or survival. Adverse effects are similar to other LHRH agonists and include tumor flare during the first week of therapy, decreased libido, decreased erectile potency, hot flashes, and gynecomastia. In combination with flutamide, additional adverse effects include diarrhea, nausea, vomiting, and elevated hepatic aminotransferases, all of which can be attributed to flutamide administration. Local reactions are minimal; however, some patients require a local anesthetic before goserelin acetate implant injection. The recommended dose is 3.6 mg administered subcutaneously into the upper abdominal wall every 28 days. The average wholesale cost is approximately +320 per month. Formulary addition is recommended.

Amino Acid Sequence↗
PubMed1999

Self Reported Sexual Dysfunction in Men and Women Treated With Bisoprolol, Hydrochlorothiazide, Enalapril, Amlodipine, Placebo, or Bisoprolol/Hydrochlorothiazide.

Quality of life may be impaired by antihypertensive therapy. Perceived sexual dysfunction by antihypertensive drugs diminishes quality of life and results in noncompliance with antihypertensive therapy. To assess the impact of various classes of antihypertensive therapy vs. combination therapy, self reported adverse reactions were catalogued by gender using COSTART (Coding Symbols for Thesaurus of Adverse Reaction Terms) of impotence or libido decrease in six randomized, blinded, prospective trials in which subjects received placebo, 5 mg qd-20 mg bid enalapril, 2.5-10 mg qd amlodipine, 6.25-25 mg qd hydrocholorothiazide (HCTZ), bisoprolol 5 mg qd, or a combination of 2.5-10 mg qd bisoprolol/6.25 mg HCTZ. The average duration of drug exposure was 6-14 weeks (range of 1 day to 23 weeks). Comparison among groups was performed using Fisher's exact test. There was no statistical difference between treatment with respect to impotence (p equals 0.688), decrease in libido (p equals 0.970), or overall sexual dysfunction (p equals 0.705) for 1251 men. Of the 661 women studied, decrease in libido was reported in only two subjects. It is concluded that short term exposure to antihypertensive drugs is associated with self reported impotence at no greater prevalence than it is with placebo in men. The combination of bisoprolol/6.25 mg HCTZ is not more likely to be associated with sexual dysfunction than placebo, HCTZ, bisoprolol, enalapril, or amlodipine. Also sexual dysfunction is reported less frequently in women than men. (c)1999 by Le Jacq Communications, Inc.

Journal Article↗
PubMed1995

Assessment and treatment of impotence.

Impotence is a common problem. History is primarily relied on to diagnose psychogenic impotence. Sex therapy is an effective treatment. Antihypertensive and psychiatric medicines often cause impotence, but most medicines should be considered a cause if this is supported by the history. Hormonal causes should be suspected in a patient with decreased libido or decreased testicular size, and testosterone should be measured in these cases. Hormone replacement may restore sexual function in hypogonadal men. Doppler sonogram or arteriography should be used to diagnose vascular impotence for men who would be good surgical candidates. Only young men without other illness are considered. There is little need to test neurologic function because there is no specific treatment for neurogenic impotence. These patients and patients who do not respond to the aforementioned treatments should be offered the vacuum erection device, penile self-injection therapy, or penile prosthesis. Choice depends on comorbid illness as well as patient preference. A basic algorithm for the evaluation and treatment of impotence is given in Figure 2.

Algorithms↗
PubMed1998

The role of cytokines in infection-related behavior.

Infections are associated with a specific behavioral pattern that includes hypomotility, hypophagia, increased sleep, decreased libido, and decreased exploration. This behavioral response is considered adaptive and important for the survival of the animal. A similar behavioral pattern was observed following treatment with endotoxin (lipopolysaccharide [LPS]) and cytokines, such as interleukin-1 (IL-1). Because the secretion of these cytokines is induced by LPS and infections, it is possible that they mediate the behavioral responses to infection. We have studied ingestive behavior and locomotor activity in mice following infection with influenza virus, or injection of LPS, IL-1, or IL-6. A lethal dose of influenza virus, LPS, IL-1a and IL-1b each decreased the intake of sweetened condensed milk and 24-hour food pellet intake and decreased locomotor activity. Mouse IL-6 was ineffective. A sublethal dose of influenza virus decreased food pellet intake and locomotor activity, but did not significantly alter milk intake. Indomethacin prevented the behavioral responses to IL-1, and attenuated those to LPS, but had only a very small effect on those to influenza virus. Similar results were obtained with the IL-1-receptor antagonist (IL-1ra); it completely prevented the responses to IL-1, attenuated those to LPS, but, even after chronic high dose administration, attenuated the effects of influenza virus infection only slightly. Our results suggest that while IL-1 may play an important role in the responses to infection, IL-6 does not. Moreover, IL-1 cannot be the only factor contributing to the altered behavior of LPS-injected or influenza virus-infected mice.

Animals↗
PubMedDate not supplied

Finasteride: the first 5 alpha-reductase inhibitor.

Finasteride is a synthetic 4-azasteroid that is a specific competitive inhibitor of 5 alpha-reductase, an intracellular enzyme that converts testosterone to dihydrotestosterone (DHT). It has no binding affinity for androgen receptor sites and itself possesses no androgenic, antiandrogenic, or other steroid hormone-related properties. It is well absorbed after oral administration, with absolute bioavailability in humans of 63% (range 34-108%). The mean time to maximum concentration is 1-2 hours, and it is approximately 90% plasma protein bound. The elimination half-life averages 6-8 hours. The agent is metabolized to a series of five metabolites, of which two are active and possess less than 20% of the 5 alpha-reductase activity of finasteride. Little is known about potential drug interactions, although they appear to be minimal and not clinically relevant. The drug is indicated for the treatment of symptomatic benign prostatic hyperplasia. Its efficacy in regression of prostate gland enlargement is rapid and predictable, although correlation with subsequent improvement in urinary flow and symptoms is highly variable. Dosages of 0.5-100 mg/day regress prostate enlargement; the recommended dosage is 5 mg once/day. Finasteride may hold promise for other DHT-mediated disorders such as acne, facial hirsutism, frontal lobe alopecia, and prostate cancer, but its use in these conditions remains investigational. The frequency of adverse drug events is low, with the most common side effects being impotence, decreased libido, and decreased volume of ejaculate. No reports of intentional overdose have been reported, and dosages of up to 80 mg/day for 3 months have been taken without adverse effect.

5-alpha Reductase Inhibitors↗
PubMed1992

Is routine endocrine testing of impotent men necessary?

Endocrine screening of impotent men is performed in an effort to identify a treatable cause of impotence. However, the prevalence of endocrinopathy in this patient population is low. We determined whether any historical or physical findings obtained during the initial office visit would identify a subgroup of patients at risk for endocrinopathy to decrease the cost of endocrine screening. The results of routine endocrine screening of 330 consecutive impotent patients formed the basis of this study. A total of 7 patients (2.1%) had endocrinopathy. Testicular atrophy was observed in 5 of these 7 patients and 6 reported decreased libido. All of the patients with endocrinopathy had either decreased libido or bilateral testicular atrophy. Our results indicate that the cost of impotence evaluation can be decreased by screening only those patients with clinical signs of hypogonadism, that is either decreased libido or bilateral testicular atrophy.

Diagnostic Tests, Routine↗