The opiate analgesics are closely related with the diminution of libido and with the emergence of erectile dysfunctions as with alterations on ejaculations, most of the times the abuse of this type of medicines is associated with sexual disorders. Great part of the sexual disorders reported in this category is associated to the methadone and heroin; however it is believed that reported effects are common to all types of opiates, which stimulate the release of prolactin with the consequent diminution of the levels of testosterone and the suppression of the central nervous system which is responsible for the alterations on the sexual response, on the other hand these effects are reversible by removing the medication.
Estrogens, anabolic steroids and corticosteroids produce suppression on the hypothalamic-pituitary-gonadal axis due to the diminution of the release of testosterone which leads to a diminution of impotence and libido. Androgenic anabolic steroids can also produce azoospermia and testicular atrophy. The use of estrogens for certain treatments can produce the diminution of libido and sexual impotence of men.
Some agents of this group such as melphalan, cyclophosphamide, chlorambucil and busulfan have been related with the diminution of libido and the emergence of erectile dysfunction. The publications related to this incidence are scarce and to this it has to added factors like the disease which is being treated, stress and other psychological factors which make more difficult to evaluate the role of the medicines on the sexual performance of the individual.
Other agents such as cytosine arabinoside, vinblastine and procarbazine, which can produce a sexual dysfunction, have also been related to a decreased libido, endometrial hypoplasia and gynecomastia.
The antihistamines can produce male sexual impotence, a diminution of libido and gynecomastia. These effects depend on the dose of the medicine, since they appear with more frequency in the treatment of hypersecretory states which require a higher dose; these effects are reversible when the medication is removed. The diminution of the levels of testosterone could explain these adverse effects. According to the opinion of the manufacturers the pantoprazole and the misoprostol can produce impotence although the relation between these medicines and sexual dysfunctions has not been clearly stated.
There are many publications about a wide variety of drugs associated with different sexual disorders; some of them are listed below:
- The Baclofen is associated with alterations on the ejaculation and male sexual impotence;
- The cyclobenzaprine os associated with sudden diminution and increment of sexual desire;
- The demeclocycline is associated with low levels of libido juts like the digoxin;
- The diethylpropion is associated with a wide variety of male sexual dysfunctions and a decrement of the levels of sexual desire;
- The gabapentin is associated to male sexual impotence and anorgasmia;
- The Interferon is also related to male sexual dysfunction, with erectile problems and with an important decrement of sexual desire;
- Antifungals such as ketoconazole and itraconazole are also related with the emergence of male sexual impotence.