What’s behind my flagging libido?
London - As many as two million British men - and almost twice as many women - are said to suffer from low libido.
So claim the drug companies, for whom sexual problems represent a potentially huge new market; Viagra sales alone are worth £316-million a year worldwide.
Which is why the manufacturers are busy developing all kinds of new treatments for men and women - only last week came the news of a faster-acting libido pill for men.
But even if millions of Britons really do suffer from a poor sex drive, is treating the problem with drugs the answer?
In fact, the solution might be much simpler. For, as the experts reveal, many of our daily habits - from the cold remedies we use to the food we eat - could be behind that flagging libido ...
EATING too much white bread and other refined carbohydrates can sap your sex drive, says Helen Bond of the British Dietetic Association. “Foods such as white bread release the sugar more quickly than their wholegrain counterparts - and too much sugar is associated with energy slumps, which mean you won’t have the energy for sex,” she adds.
Too much sugar also makes you fat, raising the level of oestrogen in the body, in turn reducing testosterone levels in men, says gynaecologist Peter Bowen-Simpkins, medical advisor to the charity Wellbeing of Women: “If you’re obese, you feel less attractive. You also have reduced blood flow to the sex organs.”
Although commonly thought of as a male sexÊhormone, women also need testosterone to have a libido.
COLD & FLU REMEDIES
OVER-THE-COUNTER cold and flu remedies are well-known libido dampeners, says Dr John Tomlinson, a GP specialist in men’s sexual health and trustee of the Sexual Advice Association.
Those that contain diphenhydramine or pseudoephedrine not only affect your sex drive but can cause erectile dysfunction, he says.
“Why this is so is not clear, but I have certainly seen it in my patients,” he adds. “It won’t happen to everyone, but if your libido is already fragile, then it could knock you off your perch.”
Meanwhile a study by the Cleveland Clinic in Ohio found that antihistamines might lead to problems with ejaculation for men and hamper both men’s and women’s libido. The researchers suggested they might affect part of the nervous system connected with sexual arousal and orgasm.
AN ESTIMATED one in four British women doesn’t get enough iron from their diet, and iron deficiency is known to leave your libido lagging, says Dr Radha Modgil, a GP in West London with a special interest in sexual health.
“Low iron levels are thought to reduce the quality of blood flow and so sap energy,” she explains. “If you’re exhausted, sex is obviously the last thing you feel like doing.”
“The best source of easily absorbable iron is a nice juicy steak,” adds Helen Bond. “Red meat like steak helps release key amino acids from the brain which are important for good mood.”
“Red meat is also a good source of B vitamins, which help convert the carbohydrates we eat into energy. It’s also a rich source of zinc, important for the production of the sex hormone testosterone, which women also need for sexual desire. Other good sources of zinc include beans, nuts and oysters.”
BLOOD PRESSURE PILLS
“THESE can sometimes significantly reduce libido and cause erectile dysfunction,” explains Dr Graham Jackson, consultant cardiologist at Guy’s & St Thomas’s Hospital. “Because they reduce heart rate and blood flow, not as much blood gets to the genitals.”
The worst offenders are diuretics and beta-blockers such as propranolol and atenolol, according to a review of blood pressure medication in this month’s issue of International Journal of Clinical Practice. The report adds that patients treated with a newer type of betablocker called nebivolol improved their erectile function by 69 percent. However, never stop taking medication without consulting your GP first.
AN APPLE-SHAPED FIGURE
“INCREASED waist circumference, or being an apple shape, reduces the amount of a protein called sex hormone-binding globulin (SHBG) which is produced in the liver,” explains Dr Mark Vanderpump, consultant endocrinologist at the Royal Free Hospital in London. “This protein is vital as it attaches itself to testosterone and transports it around the body. If you have less of the protein you’ll have a lower concentration of testosterone, too.”
Last week it was reported that men who take the hair loss drug finasteride, also known as Propecia, can experience prolonged periods of low libido. Dr Michael Irwig, assistant professor of medicine at George Washington University School of Medicine and Health Sciences, discovered that 94 percent of men taking finasteride developed low sexual desire, 92 percent suffered from erectile dysfunction and 69 percent experienced difficulty with orgasm.
The study, to be published in the Journal of Sexual Medicine, is the first to show that symptoms persisted for at least three months in otherwise healthy men, even when they stopped taking the drug.
It’s thought the drug alters levels of important brain chemicals called neurotransmitters that affect mood and other bodily functions.
LOSING WEIGHT TOO QUICKLY
“Many women try to get thin so they are more attractive, but the irony is it can kill their sex life and defeat the point of trying to be thin in the first place,” says GP Sarah Brewer. Losing weight too fast can disturb the hormones and even affect fertility, she says.
“If you lose more than 10 percent of your body weight very quickly, then your body goes into red alert and thinks you are starving it. Your level of sexual interest and enjoyment fall because the lack of nutrients means it wouldn’t be a good environment for a baby to grow in.”
Opiate-based painkillers such as codeine and morphine can suppress activity in the hypothalamus - an area of the brain that’s involved with controlling hormone levels, says Neal Patel of the Royal Pharmaceutical Society. “This, in turn, causes a release of hormones from the pituitary gland that suppress libido.”
Indeed, a study published in the Journal of Clinical Endocrinology and Metabolism found that almost 95 percent of men and 68 percent of women receiving opioid medicine long term reported a decreased sex drive. The effect is linked to how long and how high a dose of opiate you are taking.
“If you’re worried about your sex drive, then stick with painkillers such as paracetamol and ibuprofen,” adds Mr Patel.
HERBAL LIBIDO BOOSTERS
There are dozens of herbal remedies promising to pep up your libido, but some may do more harm than good, warns Dr Tomlinson.
“Just because something is natural, it doesn’t mean it is safe,” he says. “As with any of these products - for libido or otherwise - some of them really are very dangerous, and I would advise against buying anything off the internet.
“Some products are made in appalling conditions in Asia and can actually be poisonous. Others may be laced with traces of heavy metals which could negatively affect your libido.”
When it comes to sex, good blood flow is important, says Dr Tomlinson.
“Not only does diabetes cause nerve damage, which means you’re less sensitive to touch, but 50 percent of men with diabetes will eventually suffer from erectile dysfunction (caused by narrowed arteries and nerve damage) and low testosterone, which are huge reasons for low sex drive.”
A ROMANTIC three-course meal doesn’t translate into action in the bedroom, says dietician Helen Bond. In fact, you’re better off having sex before you go to the restaurant.
“Rich, carbohydrate-heavy meals cause a huge energy slump about two hours later, what’s known as postprandial dip.
“As your body focuses on digesting the food, you’ll feel sleepy and hardly in the mood for sex by the time you get home.”
Ironically, many contraceptive pills can also be passion-killers, says women’s health expert Dr Marilyn Glenville: “The hormones in the Pill trick your body into thinking you’re already pregnant and don’t need to reproduce. Also, by preventing ovulation, the Pill also lowers levels of testosterone.”
A study of 1,000 women at University Hospital of Tbingen in Germany found that those who used a hormonal method of birth control - mostly oral contraceptives - had lower levels of sexual desire and arousal.
“Testosterone is the main hormone that controls sexual desire, but the level slowly declines with age,” explains Dr Tomlinson. “A man in his 70s has only two-thirds of the testosterone he had in his 20s.
“Some men will find that they just don’t feel ‘right’ - they feel tired, crabby, their sex drive has diminished and if they take a Viagra-like tablet (Viagra itself, Cialis or Levitra), it doesn’t always work properly. Although it tackles the mechanics of erectile dysfunction by improving blood flow, it doesn’t boost testosterone and, therefore, desire.”
Note, too, that two-thirds of men with erectile dysfunction have early onset coronary heart disease, in which no other symptoms - such as chest pain - are present, says consultant cardiologist Dr Jackson.
Diabetes, thyroid disease and pituitary disease can also cause problems in the bedroom, so if you have a problem with erectile dysfunction, see your GP to have a testosterone test and rule these out.
Dr Vanderpump adds that it’s important to have a 9am test as that’s when the level is most accurate - it can be way off at other times of the day.
TRYING FOR A BABY
Many people trying for a baby have no idea of the negative effect it can have on their sex life, says fertility expert and midwife Zita West.
“Love-making becomes pressured and mechanical, and many men have performance anxiety. It soon goes away if you try to relax about ovulation times.”
Selective serotonin reuptake inhibitors - a modern family of antidepressants including Prozac (fluoxetine), Seroxat (paroxetine) and sertraline - cause a loss of libido and delayed orgasm in the majority of people who take them, says Professor David Taylor, director of pharmacy and pathology at South London and Maudsley NHS Foundation Trust.
In fact, they are sometimes prescribed to patients suffering from premature ejaculation for this very reason.
“These drugs work by increasing levels of serotonin, a brain chemical that stimulates certain receptors in the brain to improve mood,” he explains. “However this also stimulates other receptors which appears to lower libido.”
A new drug called agomelatine (or Valdoxan) does not cause these sideeffects, nor does mirtazapine (Avanza, Zispin).
However older antipsychotic drugs such as haloperidol (Serenace) and chlorpromazine (Largactil) and some newer ones such as risperidone (Risperdal) also affect sexual desire in up to three-quarters of people who take them.
Sexual Advice Association, www.sda.uk.net - Daily Mail