A widespread problem that is increasingly endangering the harmony of the couple. Is it due to stress or a pathology?
A stressful and hectic life, eating disorders or particular pathologies can lead to a decline in male sexual desire. And the difficulty inevitably has repercussions on the relationship with the partner.
What are the main triggers of the decline in desire and related risks?
In the first place there is certainly stress, people cannot get away from work and this affects sexual desire. Then there may be some relationship problems in the couple. We add the fact that testosterone production normally regresses by 2 percent a year. If, on the other hand, we encounter regressive pathologies or disorders, the discourse can be extended. In diabetic patients with high cholesterol, hypertensive or obese, for example, a decrease in desire is more likely, because they usually have a lower level of testosterone than normal and are more likely to have erectile dysfunction. Anorexia can also affect a lot: exactly as in the obese woman this disease leads the patient to amenorrhea, making her infertile because she doesn’t ovulate, while in the sick man she reduces sperm production and testosterone levels with a consequent decrease in desire. Finally, there are problems, however not frequent, linked to prolactin hyperproduction.
The decline in desire has consequences. First of all, negative repercussions on the couple’s relationship and on a physiological level on fertility, which is undermined by the scarcity of relationships. A danger that today also affects younger couples.
Prolactin is a hormone that, in women, is stimulated by estrogen in the months before giving birth and by sucking the nipple after giving birth, and is very important for breastfeeding. We know that this hormone increases in humans during orgasm, giving the sensation of post-orgasmic ‘satiety’, but the physiological role in the male is not further known. At excessive levels, however, prolactin, which affects the pituitary and hypothalamus, reduces the production of sperm and testosterone, which leads to a decline in desire. Some studies are also trying to verify if an excessively low level of prolactin leads to premature ejaculation. The frequency of cases in which prolactin is excessive and causes a decrease in sexual desire (sometimes it can also cause impotence) is quite low, but it is in any case curable.
How do I know if I have an excess or a defect in prolactin?
Excesses of prolactin may be due to hypothyroidism, renal or hepatic failure, they may be due to idiopathic causes (ie no apparent causes) such as stress or even to taking some drugs, such as prokinetics. They are antidopaminergic drugs of fairly common use and are administered to patients who struggle to swallow or digest. Very rarely hyperprolactinemia is consequent to a pituitary adenoma (ie a benign tumor of the pituitary gland), treated with the simple intake of a tablet. To find out if you are in hyperprolactinaemia, a blood test is performed with a request to monitor this hormone, but sometimes the stress caused by the extraction itself can distort the results. In Humanitas we also highlight macroprolactin (large molecules of prolactin aggregates that accumulate in the blood) to exclude it from the results. The symptoms of hyperprolactinemia are attributable to gynecomastia (ie an increase in breast volume), a decrease in desire and more rarely to delayed ejaculation.
How do I distinguish whether it is due to a pathology or an incorrect lifestyle (little physical activity, wrong nutrition, too much stress)?
It is not easy to draw a boundary because when the decline in desire is linked to a pathology, other disorders or problems usually occur simultaneously or later. I believe that the minimum amount of time that must pass to begin to consider the decline in sexual desire as a problem in itself is about three months, but this varies from case to case, depending on many factors and previous experiences.
When should I contact a specialist?
It is best to do this whenever you find that the problem is somehow affecting the life of the couple. It is advisable however, as soon as the problem arises, to talk about it with the family doctor.
The family doctor and the andrologist (if any were needed) will first have to establish whether the patient uses drugs that interfere with sexual desire.
How can Dostinex help restore sexual health?
There are effective drugs to treat erectile dysfunction and premature ejaculation, but as regards the decline in desire there are no pharmacological remedies: there are no aphrodisiacs. Testosterone increases the desire only on the patient who actually has a deficiency and it is important to the patient to administer it because he will not only have problems with sexual life, but also because testosterone is important for many functions of the body (for example in the maintenance of calcium content in the bones, of the correct lipid profile, of the fat-to-fat mass ratio, in reducing the cardiovascular risk, and in maintaining the right mood and ‘general well-being’ of the patient); in fact those who have testosterone levels below the norm have a duration and quality of life lower than normal subjects.
When the cause is hyperprolactinemia, once the correct diagnosis has been made, it is always possible to carry out an adequate treatment in order to bring the blood levels of prolactin back into the normal range, thus resolving the disorders in the sexual sphere. Sometimes a simple interview with the family doctor or with the endocrinologist / andrologist specialist can be useful to solve the problem. It is always important to carry out basic checks and then continue with the help of couple psychological treatments.
If hyperprolactinemia diagnosis is established, taking Dostinex at a starting dose of 0.25mg – 0.5mg (based on overall health condition and the levels of prolactin) can help achieve the following health benefits within the first two weeks:
- Increased sexual drive
- Restored erectile function
- Stable penile hardness with every erection
- More sexual enjoyment
- Brighter orgasms
- Shortened recovery time after ejaculation
- Boosted sexual stamina.
The doctor will determine the minimal effective dose in your case; it is important to take a full course of Dostinex and follow prescriber’s instructions responsibly. You can find more information on manipulating prolactin levels in order to improve the quality of sexual life here.