- Today we are talking about SSRIs and sexual dysfunction.
A lot of you have asked about it,
so let's just get right into it.
(lighthearted music)
So, like I said, we're gonna talk about sexual dysfunction.
I received many questions, and one in particular
I remember was a few live streams ago.
Someone asking about being on an SSRI
and that giving them erectile dysfunction
and why that was.
And I thought I could easily look it up.
And my initial thought was, ooh, it's serotonin.
I remember reading about that somewhere.
But it was not that simple.
I actually ended up having to do a lot more research
than I anticipated.
And I kept digging and digging until I found
a really great Post Hawk analysis study
where they talked about all the studies
that had been done, all the goods and the bads
and the uglies, and ended up actually coming up
with a conclusion that we don't really know why.
And so, I'm gonna talk about three neurotransmitters
with you today that we know may be involved
in sexual functioning.
And SSRIs definitely target these neurotransmitters
and could lead to sexual dysfunction.
Sexual dysfunction meaning I may not be interested in sex.
I may not be able to achieve orgasm.
I may not be able to get it up if I'm a guy.
There are a lot of different parts to sexual
functioning as a whole, so that kind of runs the gamut.
Being interested in it, being able to have it,
and being able to achieve an orgasm.
So there are three neurotransmitters,
like I said, that we know are involved
in sexual functioning.
And that is serotonin, norepinephrine,
and dopamine, and I'm gonna go in that order
as I talk to you about what we know
with regard to those neurotransmitters
and how they work in our brain
and how they affect our ability to function sexually.
Okay, and try to stay with me.
I'm gonna try to be as clear as possible.
But I know this is a lot, so you may not to pause it,
rewind, go back, all of that stuff.
While I do my best to make this as clear as possible, okay?
So the the first neurotransmitters I'm gonna
talk about is serotonin. (beep)
And that was actually the one
that I thought was involved in this.
When I got that question on my live stream,
I want, I think I might have even said,
I think it's serotonin, but I'm gonna have to look
into that because that's what I had heard.
But the truth about serotonin is,
and I'm looking at my notes,
just to tell you what it is first.
Serotonin is a monoamine neurotransmitter,
which means it contains one amino group, monoamine.
Mostly found in our GI tract, interesting,
blood platelets, and our CNS,
our central nervous system.
And so,
it's known to regulate our mood, appetite and sleep,
and it's also involved in memory and learning.
So, linking serotonin to sexual dysfunction
has actually turned out to be inconclusive.
What they find is that there are no agents,
actually, no SSRIs or SNRIs out there
that are purely serotonergic.
Meaning that they only work on our serotonin.
They always hit other things, whether it's dopamine,
norepinephrine, any other number of neurotransmitters
or hormones in our brain.
And so, they're not really able to tell us
if serotonin is actually the culprit or not.
Because unless we have all the other things removed,
we just can't tell.
So, what they find is that serotonin, what they do
know about it is that it may modulate
or sexual functioning, meaning maybe make it
a little less or a little more,
but it's not completely inhibitory.
It's not gonna stop us from being
to get an erection, be interested in sex,
achieve orgasm, any of that stuff.
Onto the next neurotransmitter.
Norepinephrine.
Now, norepinephrine is a hormone is a neurotransmitter.
It's released by our is CNS, our central nervous system
and is part of our autonomic nervous system.
So it resides in areas of the brain,
and it's general function is to mobilize
the brain and body for action.
It's the lowest, so that means that it gets us
ready to go, gets us ready to move.
And so, it would be at its lowest,
so our norepinephrine levels would be low
when we're at sleep,
when we're resting, right?
There's no need for it then.
And it has been used to treat dangerously
low blood pressure.
So, in a way, it gets our body up like,
hey, ready to rock and roll,
that's kind of the roll that norepinephrine serves.
Now, the link that they made to SSRIs
in one of the studies I read said that
if norepinephrine is blocked,
because a lot SSRIs do block norepinephrine,
it has a significant anticholinergic effect.
Now, stay with me, I know you're like, Katie,
this is not making any sense.
But an anticholinergic effect means that
it slows or inhibits involuntary movements.
This could be in the GI tract.
Like involuntary movements of moving my food along
and helping me digest things.
It also, in the urinary tract,
like getting us ready to pee,
processing all of our liquids
and making sure that that happens properly.
These are things, that's why they call it
the autonomic nervous system.
Those are things that happen almost like automatically.
I don't have to do anything to make these occur.
They occur on their own.
And so, which this could affect our ability
to get and sustain an erection
because you don't actually have to do something to get it.
Oftentimes we can get an erection or be sexually
interested in something without taking
any particular action or doing something.
We can obviously stimulate ourselves
to get ourselves excited,
but being interested in sex and actually getting an erection
sometimes happen involuntarily.
And that's why they believe that norepinephrine
is involved in our sexual functionality.
Now, the third and final neurotransmitter
I'm gonna talk about today is dopamine.
Now, dopamine in the brain functions
as a neurotransmitter.
So, when we find dopamine in the brain,
it's a neurotransmitter.
And the dopamine pathways play a role
in reward-motivated behavior.
I thought that was really interesting to know.
I'd always thought of dopamine
as a feel good neurotransmitter.
It helps us just feel, ooh, so good.
But it's actually more about reward.
So, doing something, get the pleasant reward.
It really supports that.
So, when we receive a reward for something,
dopamine levels increase, so we feel even better.
So, in a way, you could see how it would be linked
to addictive behavior like gambling addiction,
or any kind of drug and alcohol addiction.
So if the medication that you're on
lowers your dopamine level, you could see how
it would be harder to function sexually.
It might be harder to get an erection.
It might be harder to even be interested in sex.
You might not be able to achieve an orgasm
because our kind of reward functionality
is a little bit broken.
So that's something that you could definitely
ask your doctor.
Does this medication inhibit my body's ability
to produce dopamine?
Does it lower it, does it increase it?
That could give you an idea of whether or not
the medication may affect you sexually.
So, the moral of the story,
talk to your doctor.
This is important, sex is a part of
a lot of people's lives, and it's something
that is very normal to want and crave.
And so, it's important for you to feel comfortable enough
with your physician to talk with them about this,
to ask questions about the medication,
to see if sexual dysfunction is something
that is common with it.
And know what what I'm talking about and what research shows
may not be your experience.
Everyone's experience is different, and that's okay too.
So the sooner we speak up about it, the sooner
we ask questions, (lighthearted music)
the more informed we can be when we make the decision
to either go on a medication, change a medication,
stop a medication, et cetera.
I hope you found this video helpful.
I know a lot of you have had questions about this.
And I hope that kind of sheds some light
on what's going on in our brains
and why medication may cause certain things.
But like always, talk to your doctor.
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That's some good shit right right there.
Good job, Katie, okay.
And the third and final neuro, neuro, bloblublu.