The effects of anti-hypertensive drugs on sexual function in men and women: a report from the DHSS Hypertension Care Computing Project (DHCCP).

One thousand, two hundred and eighty-five men and 1,080 women being followed in the DHSS Hypertension Care Computing Project answered the questions on sexual activity included in a self-administered questionnaire. In men, both impotence and sexual inactivity were increased in patients receiving hydralazine. No gross excess of these complaints could be determined in patients receiving either beta-adrenoceptor blocking drugs or methyldopa, nor was failure of ejaculation increased with these drugs. The survey could not exclude any deterioration in sexual function occurring uniformly across all treatment groups. However, the rates of complaint were similar in men taking a diuretic alone, a beta-adrenoceptor blocking drug alone and those taking the combination of these two drug groups. In women with hypertension, frequency of sexual intercourse and the achievement of orgasm was not associated with the giving of hydralazine, beta-adrenoceptor blocking drugs or methyldopa.

Effects of antiandrogen-estrogen treatment on sexual and endocrine parameters in hirsute women.

Sexual activity was evaluated in 51 women with hirsutism associated with increased levels of circulating androgens before and while on combined treatment with the antiandrogen cyproterone acetate (CA) and ethinyl estradiol (EE2) and compared to a reference group of 52 subjects. The percentage of unbound testosterone (T) was higher (p less than 0.001), the coital frequency lower (p less than 0.05), and the masturbation frequency higher (p less than 0.04) in hirsute women. Mean frequency of total activity (coitus plus masturbation) was similar in the two groups. Treatment with combination of CA and EE2 resulted in a decline of unbound T (p less than 0.001). There was no change of total sexual activity, but coital frequency increased (p less than 0.05) and masturbation frequency declined (p less than 0.04). It is concluded that raised levels of circulating androgens, as judged by free T concentration, are not of crucial importance in the expression of sexual behavior in hirsute women.

The human sexual response and alcohol and drugs.

The effects of alcohol and drugs on sexual function are important to consider in clinical histories and medication prescribing practices. Virtually all aspects of the human sexual response are affected by alcohol and drugs: 1. Desire (libido) is reduced. 2. Performance. Impotency as defined by lack of erection and ejaculation occurs. 3. Dissatisfaction ensues. These effects of alcohol and drugs can be understood and illustrated by examining the phases of excitement, plateau, orgasm, and resolution in the human sexual response. The important first step in the treatment of sexual dysfunction is to identify the alcohol/drug/medication use. The next is to recognize the profound effect it can have on the human sexual response. Furthermore, knowledge of the mechanism of action of the drugs and a basic conception of the physiology and psychology of sexual performance are necessary to predict the course of the sexual dysfunction. In many instances, the sexual dysfunction is reversible even after chronic alcohol/drug/medication use.

The effects of oestrogen therapy on the sex life of post-menopausal women.

The literature concerning sexual behaviour around the time of the menopause is reviewed. Mentioned is a decline in sexual activity and satisfaction in women which is attributed to the changes in the women themselves, and not merely a reaction to the decline in the sexual capacity of their husbands. Forty women were treated during 1 yr with oestrogens. The eventual effect of this treatment on sexual activity and satisfaction was investigated and compared with a group who had undergone partial treatment only. The results show that in the completely treated Group A, symptoms such as hot flushes and depression diminished, and the pain of sexual relations was relieved. As a consequence of this improvement, coital activity and satisfaction were more gratifying. The partially treated Group B showed a clear decline in sexual activity and in sexual satisfaction.

Rise in female-initiated sexual activity at ovulation and its suppression by oral contraceptives.

This study was designed to test the hypothesis that women exhibit peaks of sexual activity at ovulation, as would be predicted from estrous effects in animals. Married women who used contraceptive devices other than oral contraceptives experienced a significant increase in their sexual behavior at the time of ovulation. This peak was statistically significant for all female-initiated behavior, including both autosexual and female-initiated heterosexual behavior, but was not present for male-initiated behavior except under certain conditions of contraceptive use. Previous failures to find an ovulatory peak may be due to use of measures of sexual behavior that are primarily determined by initiation of the male partner. Women using oral contraceptives did not show a rise in female-initiated sexual activity at the corresponding time in their menstrual cycles, probably owing to the suppression of ovulatory increases in hormone secretion by the oral contraceptives.

Cognitive and hormonal factors accecting coital frequency.

Sexual behavior of female undergraduates was assessed by daily questionnaries. Of the 24 subjects, 13 were taking oral contraceptives ("pill" subjects) and 11 were using other methods of birth control ("nonpill" subjects), primarily diaphragm or male prophylactic methods. Three main results were obtained: (1) Intercourse rates were lowest during menstruation and highest immediately following menstruation. (2) Self-rated sexual arousal on a given day correlated with the type of heterosexual encouters on that day rather than with period of the menstrual cycle. (3) Pill subjects reported intercourse on more days than nonpill subjects but reported a lower number of intercourse sessions on day with intercourse than nonpill subjects. These results are interpreted within a general framework of sexual behavior which recognizes the sexual behavior of humans as primarily influenced by cultural and cognitive factors. The possibility is discussed that female sexual behavior might also be found to be affected by hormones if more sensitive measures were used.

PIP: Coital frequency was studied in 24 female undergraduate students. 13 of the women were using oral contraceptives (OC), while the remainder used more conventional methods of contraception. The frequency of coitus was lowest during menstruation and highest in the period immediately following menstruation. Self-rated sexual arousal was correlated with the type of sexual attention paid, rather than with a given day during the menstrual cycle. OC users reported coital activity on more days of the cycle than non-pill subjects, but engaged in coitus with less frequency on intercourse days than women using conventional contraception. The results indicate that hormones have very little influence on eroticism and sexual activity in humans. Rather, learning and cultural conditioning are the principal factors guiding human sexual activity.