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.

Gonadal and sexual function in male patients with hairy cell leukemia: lack of adverse effects of recombinant alpha 2-interferon treatment.

Gonadal and sexual function was evaluated in 81 male patients with hairy cell leukemia (HCL). Forty-eight patients were receiving recombinant alpha 2b-interferon (INF) therapy, and 33 patients were receiving no systemic therapy at the time of evaluation. Among 28 patients with stable HCL who were receiving no systemic therapy, elevated serum follicle-stimulating hormone (FSH) was observed in two patients, while serum luteinizing hormone (LH) was normal in all. Serum testosterone levels were below normal in seven of 28 patients on no systemic therapy. Hormone levels were followed prospectively for a median of 8 months in 11 patients receiving INF without prior chlorambucil therapy. FSH became elevated in only one of eight patients with normal pretreatment values, LH remained normal in all patients, and testosterone transiently fell in two of four patients with normal pretreatment values. In addition, 20 of 29 patients receiving INF who had normal FSH and LH levels when first examined continued to have normal levels during a median of 10 months of INF therapy. Patients receiving INF generally reported either no change or improvement in sexual function as therapy progressed. We conclude that most patients with stable HCL have normal testicular function and that INF therapy does not appear to produce significant gonadal toxicity.

Effect of treatment on fertility and sexual function in males with metastatic nonseminomatous germ cell tumors of testis.

The effects of therapy on the sexual ability and fertility of sixty-seven patients with nonseminomatous germ cell tumors of the testis were analyzed. Ten of 38 patients had subfertile sperm counts before therapy. Normal ejaculation was preserved in only 7/61 patients who underwent retroperitoneal lymph node dissection. In five of these patients, sperm analysis was done after chemotherapy; all had complete azoospermia. An effort to restore ejaculation with imipramine yielded only minimal response in 4/9 patients who received this drug. No major long-term effects on the libido were observed.

Pharmacosexology: the effects of drugs on sexual function a review.

The literature on the sexual side effects of drugs and chemicals has been reviewed. There are many substances which alter the human sociosexual response cycle either negatively, positively or both. Many of the drugs used therapeutically have been reported to have adverse effects on sexuality, and this must be taken into account when these drugs are used clinically. Many substances which are used for recreational purposes (or sometimes abused) also have profound effects on sexual response. Many of these substances are used in such a way that they can correct underlying sexual problems. Treatment of a drug abuser may well prove unsuccessful without consideration of preexistent sociosexual problems and concerns. From the dawn of recorded history, many substances have been used for the purpose of sexual enhancement. Some of these have known success and their reputations have been passed down through the millenia. The chapter has not yet been closed on aphrodisiacs, even though none have survived the rigors of scientific scrutiny. As long as humans place value on optimal sexual functioning, there will be a demand for sex-enhancing drugs. In order for the scientific and medical community to successfully meet these challenges, more effective and relevant study designs will have to be utilized in order to separate fact from fancy. The study of pharmacosexology is in its infancy, and in order for it to grow and contribute to the world body of knowledge, more researchers and clinicians must be trained in both pharmacology and sexology.

Androgens and human sexual behaviour.

Androgens are generally believed to be necessary for normal sexual responsiveness in the human male and female. The evidence for this is limited and sometimes conflicting. This paper considers evidence from experiments in which exogenous androgens are given to people with impaired sexual response. Results from a study in which testosterone was given to unresponsive women are reported, together with the preliminary results of giving androstenedione to sexually unresponsive women taking oral contraceptives and giving testosterone undecanoate to hypogonadal males. In the first study, when testosterone was combined with counselling, significant effects were produced by the addition of testosterone. In the androstenedione study, where no counselling was given, beneficial effects of the androgen have been unusual. Examples of the evaluation of androgen replacement in hypogonodal males are also presented. Finally, some methodological problems of evaluating the effects of exogenous hormone in human sexual behaviour are briefly discussed.