Low Libido or also known as low sex drive is common among men. In this video, Dr. Malik reveals several pharmacologic ...

4-low-libido-treatments-that-science-says-work-but-you39ve-probably-never-heard-of

4 Low Libido Treatments That Science Says Work (but You&#39;ve Probably Never Heard Of)!

do you suffer from low sex drive well what can you do about it I'm Dr Rena Malik urologist and pelvic surgeon and today we're going to talk about the pharmacologic treatment options for low sex drive now low sex drive is pretty common it's seen anywhere from five to Seventeen percent of men and that's probably less reported than it actually exists because a lot of men don't come see their doctor now remember low sex drive is when you have a persistent absence of sexual desires or fantasies that causes you bother or distress that then affects your quality of life so when we're treating low sexual desire it's important to get evaluated first to make sure there's no other underlying conditions that could be causing your low sex drive like low testosterone elevated prolactin abnormalities in your thyroid hormone so on and so forth because the first line of treatment is then focusing on fixing that problem that will then reassess your sex drive to see if that's improved your libido but what if everything as normal and you have what we call primary reduced libido we're going to talk about four different things that you can try first Is bupropion now remember all of these things are generally off label there has been some study in women but even much less in men so bupropion is actually an FDA approved antidepressant medication and it's also used generally to treat depression and seasonal affective disorder and has also been used to help with quitting smoking how does it work well it's not exactly clear the thought is that it prevents the re-uptake of neurotransmitters called norepinephrine and dopamine in a small study looking at people taking 12-week trial of bupropion they found that those who got propropion versus a placebo were significantly more likely to see improvements in libido and sexual function with about 63 percent of people taking the medication seeing an improvement compared to only three percent in the placebo group and the Improvement bit because this was both men and women was actually more prominent in the male cohort with 86 percent of men showing Improvement compared to only 44 percent of women and generally it was pretty well tolerated with side effects including weight loss nausea agitation and insomnia but nothing major that people reported having to stop the medication for and in more recent studies they're actually looking at a combination of bupropion and trazodone looking for female hypoactive sexual desire disorder and that is actually showing better results compared to bupropion alone but there's no data in men yet number two is phlebancerin also known as brand name Addie now this is an approved FDA approved medication for women pre-menopausal women with hypoactive sexual desired disorder it was approved in 2015 and I made a full video about it calling it the pink pill instead of the blue pill and how it works is it stimulates some serotonin receptors and then inhibits other receptors so basically it works on serotonin receptors in the brain and through both activation and inhibition of these receptors it subsequently increasing the release of again the hormone dopamine and the neurotransmitter norepinephrine which are both really important in promoting sexual excitation in addition to that it also reduces the level of Serotonin which actually works by decreasing sexual desire so why people who are odd ssris for antidepressants do notice a decrease in desire sometimes now there is very little data for this on men but it can be used said to take in once a day at night time before bed because it can cause fatigue and if you want to learn more about it make sure you check out that video but generally risks are having a low blood pressure and having syncope or fainting and then you certainly want to watch certain medications that you're taking can interact with it number three is Brie melanotide now lot of people are taking some off-label version of this pt141 whatever but Bree melanotide is actually FDA approved again for women who are pre-menopausal with hypoactive sexual desire disorder now how this works is it is an analog of a neuropeptide called the alpha melanocyte stimulating hormone and this acts on multiple melanocortin receptors that then are involved in kind of the excitatory pathways for sexual desire and arousal and there has been more data on this in fact I made an entire video on Brie melanotide for men and it's been shown to increase both erectile function and desire in men by again stimulating these melanocortin receptors in the brain particularly in the hypothalamus now how this works is you take an injection that you give yourself about 45 minutes before you want to want and it can cause some nausea which is actually quite frequent particularly in the first dose so sometimes you can take an anti-nausea medication at the time of taking the medication it can also cause some facial flushing and headache and rare circumstances that can cause some changes in coloration under the armpits or on the breast tissue near the areolas that's if you're taking it more than eight times a month is more common now lastly DHEA so DHEA has a lot of fanfare and basically what it is it's a precursor to estrogen and testosterone it's naturally occurring in the body and it has effects in both the brain as well as in the periphery and in the brain it acts like a neurosteroid so you will see if you look up DHA people say there's many other benefits for brain health as well as sexual function now again the studies here are limited DHEA has not shown a significant benefit in libido particularly in men who have normal levels of testosterone and this is because it probably exerts its effect primarily by converting into testosterone and increasing testosterone itself now if you remember from my video on low libido a couple weeks ago that at a certain point having more testosterone doesn't really impact you very much because the saturation effect so the way DHEA is theorized to work is because it increases testosterone and estrogen so if you have normal testosterone levels it's unlikely to improve your libido and generally when you look at the data it has shown mixed results in post-menopausal women at about 100 milligrams a day it has shown a benefit in arousal however they did not see the same benefit in male population in that same study and really important to remember there is no FDA improved formulation for DHEA and in studies that have looked at DHEA concentrations in over-the-counter supplements or supplements you can buy online have shown that DHEA levels can be none or you know 40 of what's on the box or more than what's on the box so it's important to realize that when you're taking these supplements it may not be effective because it's not effective or two because you're not getting the right dose or you're getting too much there is a formulation of DHEA that's vaginal that is FDA approved called prostrone or intra Rosa that has been shown to be very effective for women with genital urinary syndrome of menopause now side effects of the DHEA that have most commonly reported are nausea and acne so I hope you guys found this helpful if you want a more in-depth video on DHEA please comment below if you enjoyed this video make sure to check out my video on how you can boost your testosterone with exercise and what specific exercises can help you boost your testosterone as always you want to take care of yourself because you're worth it

Dr.

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