My 2 Cents: Libido

Showing posts with label Libido. Show all posts

Wednesday, February 10, 2016

Q&A Session at HealthTap.com

I stop androgel 10 g dr want to gave me clomid 25mg because i lost 80% of libido and no mor energy do u think well boost my libido & energy ?

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Monday, January 4, 2016

Q&A Session at HealthTap.com

30 years old. Married with one daughter. Mow feeling to loose sexual desire and piwer. Any medicines I can take to improve ?

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Wednesday, October 21, 2015

Q&A Session at HealthTap.com

I just lost my wife of 35 years to cancer. We had a wonderful sex life .and I miss that. I would like to know if it is immoral that I want to have sex?

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Thursday, September 17, 2015

Q&A Session at HealthTap.com

Is Russian bear 10000 supplement for weight gainer cause impotency if i use it and what the side effects of this product.

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Sunday, July 19, 2015

Q&A Session at HealthTap.com

I am a man Before I sex woman two time daily but now I can't sex one time in a week?

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Friday, November 1, 2013

Q&A Session at HealthTap.com

What happens to me if all or nearly all of my testosterone is removed?

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Q&A Session at HealthTap.com

Low sex drive and early ejaculation is cause by?

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Sunday, October 13, 2013

Q&A Session at HealthTap.com

My fiancé is 27 testosterone levels are normal according to doc. He has a low sex drive he does work a lot and is tired. How can we fix it causes argu?

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Saturday, October 12, 2013

Q&A Session at HealthTap.com

Can you suck dick while sick?

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Q&A Session at HealthTap.com

Will maca 525mg help improve my mode/sex drive? Or is it all hype? What vitamins would be good for energy???

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Friday, October 11, 2013

Q&A Session at HealthTap.com

I think I might have low testosterone, but traditional treatment worries me for the effect it might have on my mood/temperament. What're my options?

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Thursday, August 8, 2013

Q&A Session at HealthTap.com

Could u pls suggest me some best OTC drugs inbindia to boost my sexual drive,hardly I last for 20 min pls help?

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Friday, August 2, 2013

Q&A Session at HealthTap.com

A male has normal testosterone levels but low LH \FSH levels. What are the chances that the low LH/FSH are the cause of a low libido? And why?

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Monday, June 17, 2013

HSDD? There's A Pill For That!

In my mind, pills are like apps. Do you have a common problem to solve? There's an app for that, as Apple has trademarked. Do you have some health related issue? There's probably a pill for that. Blood pressure? Check. Cholesterol? Check. Social anxiety? Check. Erectile dysfunction? Check. Obesity? Check. Female libido? Oops! No check! But just wait! Big Pharma is working on that! As far back as January 2005, as published in the British Medical Journal, attempts have been made to develop a misnamed female Viagra.

But let's go back to the beginning. Hypoactive sexual desire disorder. HSDD. It's a lack or loss of sex drive (libido) in women that leads to distress. It's not the same as erectile dysfunction in men which is more of a plumbing issue. Men can be troubled by ED and still be interested in sex. It's the loss of interest leading to distress that drives the definition of HSDD. Obviously (or maybe not), it's a complicated issue.

You're not going to be interested in having sexual relations w/your partner if you're upset w/him or her. You're also not going to be interested in sexual relations if you're tired from work (whether inside or outside the home), if you're worried about money or your job, if you're distracted by family & friends, etc. You're also not going to be interested in sex if you're depressed or taking certain medications of if you don't have a positive self-image.

But what if it's none of the above? That's where Big Pharma has been trying but w/o much success to find an easy to take, side effect free solution to this relatively common situation in women. This post isn't necessarily about the medicalization of the human condition (often referred to as disease mongering) but rather about the latest & greatest pill yet, Lybrido. You know it's a big deal when Popular Science does a write up on a yet to be approved drug. And as expected, the New York Times also developed a nice review of the topic. But it took a bit more digging around to figure out just what's in Lybrido: testosterone + sildenafil (the active ingredient in Viagra), as noted in the Neurocritic, a blogpost. So if you can't wait for the science to catch up with good solid evidence & proof, ask your doc for the individual medications & play mad scientist.

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Friday, June 7, 2013

Behind the Scenes: The Making of Low T

It's seems near impossible these days to pick up a magazine, listen to the radio, watch the television or drive without seeing a billboard plastered with some message related to testosterone. Just where and how did this condition (disease?) come into being? After all, hasn't low testosterone been around since men lived long enough to reach a point in their lives when levels dropped significantly? So why all the press now? Perhaps, it's partially due to the Baby Boomers reaching that very point in their collective lives since they're not about to go without a fight! Or perhaps it's due in part to Big Pharm doing its research and developing new products that need larger markets.

On a more personal level, I was recruited out of academia a decade ago to assist a private practice in growing but more importantly in giving it the research gravitas to support its attempt to corner the market on hormone deficiencies and even suboptimal hormonal levels. And so I tried to get my hands on as much peer-reviewed research as possible. Unfortunately, most of it was observational in nature, albeit over half a dozen observational studies all conclude that low testosterone is associated w/higher mortality no matter which population was studied, whether American (3 different cohorts), Italian, British or Scandanavian. Granted, there were randomized controlled trials demonstrating benefit from testosterone replacement/supplementation, but it was rarely w/o risk, and there were a few w/o any benefit at all.

Which then leaves us w/consensus statements by "thought leaders". Little did I know that many of these "guidelines" have been ghost-written by others as revealed in a special article published early online in JAMA Internal Medicine. So is low T real? Most definitely yes, but most likely not in a high enough percentage of men to warrant dramatically raising rates of testosterone prescriptions over the last decade. So what are we to do? As a clinician, let's not jump directly on the hypogonadism/andropause band wagon.

Instead, let's look for other reasons that might explain the vague symptoms that overlap with so many other issues & conditions. Stress to the relationship, family, friends, money, job security, etc. What about poor lifestyle choices such as smoking and/or drinking to excess? Any health conditions or diseases that predispose someone to loss of energy, obesity, decrease in libido, depression? Anemia? Diabetes? Hypothyroidism? How about (new) medications? In other words, don't attempt to jump on the low T bandwagon w/o a thorough evaluation by your family doc. And if you do decide to go for a test drive, so to speak, remember that testosterone replacement/supplementation/optimization is not a do-it-yourself project.

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Tuesday, April 30, 2013

ED & Heart Disease: It's All in the Plumbing Part 4

It's interesting that when it rains, it pours. Well, maybe. Or maybe it's more of the blind squirrel finding the occasional nut. In this particular case, while I was nosing around yesterday regarding the link between erectile dysfunction and heart disease, I stumbled upon yet another review published last August in the Mayo Clinic Proceedings. In fact, this review was a consensus statement of the third Princeton Consensus Conference held in November 2010 (notice how long it takes to get something published?).

Specifically, erectile dysfunction was linked to an increase risk for coronary heart disease, stroke & all-cause mortality. The group went so far as to recommend a cardiac evaluation for any man complaining of organic ED (a question raised at the AAFP's Geriatric Medicine conference last week).

More importantly, the authors pointed out a total of 9 studies linking low testosterone (or hypogonadism) to increase mortality. Granted this does not prove cause & effect, but it does compel us to set up a randomized controlled trial to address that possibility. And finally, the authors went so far as to suggest that all men w/ED should have their T level checked and replacement considered when appropriate. Wow! What a turn around!

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