Sex and effect of drugs is an important topic since many drugs that are prescribed for common conditions such as anxiety and hypertension interfere with sexual functioning. Two cases are illustrated here.
30 years old Mr. S K was married for two years. he had no premarital contact. He was childless since he advised his wife to be on oral contraceptive pills to delay conception to have uninhibited sex life. He had healthy sexual life with coital frequency of once in three days. He suffered severe financial loss and became depressed. he withdrew from social and sexual life. He went to a GP who prescribed antidepressants. Two months later he detected to be hypertensive and was started on Aten 50 mg. OD. He abstained from sex for six months until his business normalized. The happy man resumed sexual intercourse but notice impotence. He reconsulted his GP who said problem was psychogenic and send him to a psychotherapist for psychotherapy but there was no improvement. In vain attempt to prove sexual fitness, he visited CSW’s (commercial sex workers) but had poor coital response. He visited another doctor who stopped Aten and added calcium channel blockers for his hypertension and stopped antidepressants as the patients was in normal mood now. Patient started having normal coitus with wife and stopped visits to CSW’s. But by then he had contacted HIV infection and died after three years.
Mr. R.K, who was having poor erections due to a vasculogenic cause visited his GP. The GP asked for history of previous ischaemic heart disease which the patient denied. his Echo and ECG was normal. Patient was confidently started on sildnafil (Viagra). Patient died after first dose. Subsequently it was discovered that patient had central chest pain diagnosed as diffuse oesophageal spasm for which he was on nitrates.
Both cases teach us that
Libido or sex drive depends on testosterone level and emotional and physical health.
Therefore, drugs decreasing testosterone levels or affecting emotional and physical health by causing drowsiness, lethargy, weight gain or confusion reduces libido.
Androgens, neurotransmitters, L-dopa, CNS stimulants, amphetamine.