Hello! My name is Tori and I am a doctor of physical therapy who specializes
in pelvic dysfunction, which means I treat things that can go wrong
around the pelvis—and this includes sexual dysfunction.
If you haven’t, please check out the first video in this series as it introduces what’s normal
and abnormal around female libido and speaks more about my intention behind
the series—which is, in short, to walk you through how I would
approach low libido as a patient who is also a pelvic health provider.
So, today, we’ll talk about the two main factors that I would consider when it comes to
investigating medications and their connection to low libido, what resources I would use to
research, how I would translate the results, and how I would talk to my prescribing physician.
You can check the description below for timestamps
and links to any studies or resources mentioned today!
So, as you may know, certain medications can absolutely affect sex drive. But
when questioning whether or not medications
are affecting your sex drive, I think there are two important factors to consider.
One is timing. Can you remember when you started to notice a change in your sex drive?
Was it 6 months ago, a year ago, 10 years ago? Even if you can only recall a rough estimate of
when you started to notice a change, having an idea of a timeline can be incredibly helpful,
especially if you’re taking multiple medications or managing multiple conditions.
Once you’ve got an idea—even if it’s a hazy idea—of when your sex drive started to change, you
can ask yourself if that timing correlates with any new or changes in medications. Please
include both prescription and over-the-counter medications in your investigation! Remember that
some drugs can take months to elicit side-effects, so even if the timing doesn’t line up perfectly,
any new or change in medication that kind of correlates with when you noticed a change
in your sex drive is worth investigating—at least I would investigate it if it were me.
So, two important factors when questioning whether or not medications are affecting your sex drive.
One is timing. The other is whether or not low libido is a known side-effect of the drug.
I think the best known drugs with a potential low-libido side-effect are antidepressants,
but antidepressants are not the only drugs that can negatively impact your libido. Certain heart
medications, blood pressure medications, and even acid reflux medications can decrease sex drive.
Instead of listing and talking about all of the potential medications that can lower libido,
I want to show you an easy way to do this research on your own. I’m a big fan of using the national
library of medicine as a resource, but I’m fearful that if someone watching
this doesn’t live in the United States, that they won’t be able to access this website since it
is a .gov site. So I’m going to show you how to use both the National Library of Medicine and
drugs.com, as both resources are easy to use, should be
able to help you find out whether or not the drug you’re taking is known to cause low libido.
We’ll use Prozac, a better known antidepressant, for our example. The first thing you’ll need is
the name of the drug that you’re researching.The brand name, like Prozac, or generic name,
like fluoxetine in our case, will both work just fine.
If you live in the United States, you can use our national library of medicine to do
your research. I’ll link to the homepage in the description below, but simply go to the homepage,
choose “human drugs,” type in the name of the drug,
scroll down to adverse reactions, open the tab, and use the “find” command (which is command F
on apple computers, control F on other computes), and type in “libido.” You’ll discover right away
if low libido is a known side-effect of your drug. I like the National Library of Medicine because it
usually expands on its findings, like you can see in this table, here. When it comes to Prozac, this
table—representing patients using Prozac to treat depression, OCD, bulimia, and panic disorder—tells
us that anywhere from 1 to 11% of those patents reported low libido as a side effect.
If you don’t have access to the National Library of Medicine,
drugs.com will also do the trick. Go to the homepage.
Click on “side effects checker,” and type in the name of your drug. Use the find command
(that’s command F on apple computers, control F on other computers), and type in “libido.”
Again, you’ll discover right away whether or not low libido is a known side-effect of your drug.
Now, I do want to share that not all side-effects are up to date or available on
these sites. Tagamet, or Cimetidine, is a common, over the counter drug used to treat heart burn.
And, when you search it on the National Library of Medicine, there is no “adverse reactions”
tab. Similarly, when you search it on drugs.com, while there are side-effects listed, libido is not
one of them. However, when you google search “cimetidine low libido,” you will find out that
its hormonal effects, while rare, have been known to decrease libido, at least in men.
All of this to say, the National Library of Medicine and drugs.com are resources that I use
to do my own research; but if I suspected a medication may be affecting my sex drive and
neither of those resources confirmed it, I’d search outside of them just to be sure.
So, again: two important factors I would consider when questioning whether or not medications
are affecting my sex drive. Timing, and whether or not low libido is a known side-effect of the drug.
There are four possible outcomes with this model: the timing is wrong and low
libido isn’t a side effect, the timing is wrong and low libido is a side effect, the time is
right and low libido isn’t a side effect, and the timing is right and low libido is a side effect.
If the timing isn’t right and low libido isn’t a known side effect,
you can probably rule out that drug. And ruling things out
is incredibly valuable, because it brings you one step closer to your solution.
If the timing isn’t right but low libido is a known side effect, put the drug in
your “maybe” pile. Maybe it took a longer than usual time for this side effect to show up
in your body, and it is because of the drug that you’re experiencing low libido. But if
triggers other than this medication better match your timeline or your intuition,
it might be a better use of your time to investigate those first.
If the timing is right but low libido is not a known side effect, I would still keep the drug
in my “maybe” pile. I know it’s not the same thing, but GI issues did not used to be a
commonly talked about side-effect from hormonal birth control, at least not when I was trying to
cure my chronic acid reflux. It took me a while but I eventually pieced together that the only
change in my life that was kind of around the same time that I started getting heartburn was
getting on hormonal birth control. Eventually I was able
to cure my heartburn, and a huge part of that was getting off of the pill. All of this to say,
bodies are different, and they respond differently to different drugs. If the timing is right but low
libido is not a known side effect, it might be a better use of your time to investigate
other potential triggers first, especially if they also match your timeline, but the only real way to
rule out a medication is to stop taking it, or to replace it with a different drug.
Finally, if the timing is right and low libido is a known side
effect, I would try to rule in the drug.
Some medications are safe to stop taking abruptly, others need to be weaned with the supervision of
a healthcare provider. Some medications are really easy to replace, others
are incredibly valuable to the person taking them and need to be replaced delicately with
the supervision of a healthcare provider. So, whether you are investigating a drug you are
pretty sure is the culprit, or you’re pulling from your “maybe” pile—you absolutely need to
speak with your prescribing physician before attempting any changes in your medications.
And sometimes speaking to your physician feels easy, other times it feels vulnerable and hard.
If you’re struggling to find the right language, you can use what we’ve discussed in this video
as an outline. For example, if the timing is right but low libido is not a known side effect, you
could say something like, “I’ve been experiencing low libido for 2 years now. I’ve been reflecting
and doing some research, and even though low libido isn’t a side effect of *insert name of
drug here,* I do think my libido changed around the same time I started taking
this drug, and I want to find out if the two are connected. How do I
safely stop taking this drug, or what other options do I have to replace this drug?”
If talking still feels overwhelming, you can write your physician a letter using that same
outline and give it to him or her during your next appointment. Or ask a trusted friend or
family member to accompany you either for moral support, accountability, or both. Finally,
if you feel like your provider isn’t listening, isn’t interested in helping you, or like you
cannot broach this topic with him or her—I want to encourage you to find another provider.
This topic can take so much courage to investigate, and even more to talk about.
I want to remind you that even though it doesn’t always feel like it, healthcare is
a service industry. We, as providers, are being paid to serve you. You are worthy of our time,
attention, and our help, and you deserve a healthy and vibrant sex life if you want one.
On that note, thank you so much for watching! Let me know what you think of this video—my
approach to this topic is different than other content that I’ve made, and I am very open
to suggestion and criticism. So, if you found this video helpful and you like this approach, please
give the video up a thumbs up so that I know. If you don’t like the video, downvote it and please
feel free to comment suggestions, as well as questions, requests, anything down below—I do try
to read and respond to all of my comments. Don’t forget to check meowt on instagram and finally
please subscribe to my channel for more content not only about pelvic things but also about life
things. I hope you have a wonderful rest of your day and I will see you in the next video. Bye!