MEDICAL PROBLEMS that can SQUASH your libido…
By Alyssa Quimby, MD
As you’re probably aware if you’ve been following us for awhile now, libido is COMPLICATED! So many factors impact our libido from stress, to past relationships, to our cultural or religious beliefs – you name it, it probably plays a role! And not surprisingly, other medical issues we may have can also impact our libido. This happens in several ways. For some medical issues, like high blood pressure for example – both the disorder itself and the medications we treat it with can put a damper on your libido – a double whammy if you will. Today we’ll talk about 3 common medical issues and the medications we use to treat them that can have a negative impact on our sex drive. Last week we discussed 3 other medications that impact libido so if you missed it, check it out here!
HIGH BLOOD PRESSURE
Let’s start with high blood pressure also known as hypertension. Hypertension, especially over time, can damage our blood vessels and cause narrowing and even scarring. When blood vessels are narrowed, they decrease blood flow which can result specifically in decreased blood flow to our pelvic organs. Lower blood flow to our pelvis means more difficulty becoming aroused, less intense orgasms, or difficulty achieving orgasm at all. And if it’s harder to become aroused and your orgasms aren’t as good as they once were – guess what?! It’s going to lead to a drop in your sex drive!
The second way hypertension impacts libido is with the medication we often use to treat it. Hydrochlorothiazide which is on one of the most common medications used to treat high blood pressure works by decreasing salt and water in our blood vessels. It can have the side effect of decreasing blood flow further to the pelvic organs and can also decrease the amount of zinc in the body which is needed to make testosterone. When the building blocks of testosterone are compromised leading to lower production, this can decrease libido for both men and women. Beta blockers – another common class of hypertension medication, a common one is Atenolol, works by constricting some blood vessels and dilating others. Pelvic blood vessels are unfortunately constricted more which as discussed previously can lead to decreased arousal, orgasm, etc.
So what do you do about this if you are on these medications and struggling with libido? DO NOT stop your meds! Instead, schedule an appointment with your doctor so you can the possible side effects and come up with alternatives. Sometimes you can keep the same medication but lower the dose and/or add another med. Or sometimes you can be on a different type of medication all together. But whatever you do, don’t just stop without talking to your doctor! Uncontrolled hypertension can truly be life threatening and not something you want to mess with without guidance.
HIGH CHOLESTEROL
A medical condition we see often with high blood pressure is high cholesterol. And unfortunately, treatment for this can have the side effect of decreased libido as well. Cholesterol is a building block for most hormones tied to sexual function so by decreasing our cholesterol, in theory we can cause a decrease in both estrogen and testosterone levels. This is one the theories behind why statins like Zocor, Lipitor, etc can decrease sex drive. A 2009 NIH funded study looked at cholesterol medication and it’s impact on libido and found that as cholesterol levels improved on treatment, sex side effects worsened. This was more profound for men in the study but the side effect was also seen in women. And just like for hypertension medication, thankfully there are alternatives to treatment. So if you’re concerned your medication is impacting your sex drive, talk to your doctor about alternatives before you stop cold turkey!
REFLUX
Another common medical condition whose treatment can lead to libido issues is reflux. It’s estimated that up to 20% of women struggle with reflux compared to only about 11% of men – I don’t know about you but I was surprised by this! Maybe because most people of I’ve heard complain of reflux (at least outside of pregnancy) are men! But in any case, according to the data, women struggle with it more. H2 blockers are a class of medication commonly used to treat reflux. Common ones you’ve probably heard of are Tagamet, Zantac, and Pepcid. These medications work to decrease histamine which as you may remember from last week, is also involved in sexual response. In females, estrogen and histamine interact to promote female arousal. In men, histamine is important for maintaining erection. So when histamine is blocked, it can decrease female arousal and make erections more difficult. Fortunately there are other classes of medication that can treat reflux AND not everyone on H2 blockers will experience these side effects. But, if you’re someone who this information does apply to, talk to your doctor about another option for treatment!
As we’ve said time and time again – libido is complicated! There are many potential factors like chronic medical problems and medications that can interfere with it. Our hope is that with more education on possible libido busters, instead of feeling hopeless, you’ll feel empowered to make changes that can have a substantial benefit.
