The Science Behind Low Libido and How to Revitalize Your Sex Life

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In this episode, Dr. Rena Malik discusses the complex topic of low sexual desire. She delves into the prevalence of low libido in both men and women, highlighting the various factors that can impact sexual desire, including medications, relationship issues, stress, and psychological disorders. Dr. Malik shares insights on the role of the brain in sexual desire, as well as the potential impact of mindfulness practice, nutrition, sleep, and exercise on improving sexual function. She also explores the use of supplements, medications, and hormone replacement therapy as potential interventions. Join us as we explore the multifaceted nature of sexual desire and the potential strategies for addressing low libido.




Chapters

00:00 - Introduction
02:23 - Understanding the Prevalence of Low Sexual Desire and Its Impact
08:49 - The Role of the Brain in Sexual Desire: Neurological Signal Pathways
13:20 - Medications and Their Influence on Sexual Desire
18:45 - Relationship Issues, Stress, and Psychological Factors in Low Sexual Desire
24:10 - The Impact of Mindfulness Practice on Body Image and Sexual Satisfaction
29:57 - Nutritional and Lifestyle Factors Affecting Sexual Desire
34:18 - Scheduling Intimacy and its Role in Awakening Desire
39:02 - Communicating with Your Partner for a Fulfilling Sex Life
43:50 - Medical Solutions for Low Libido:
48:15 - Conclusion
 
 

*Testosterone replacement therapy can improve several aspects of sexual life, including erection, only in hypogonadal subjects but its contribution alone is clinically effective only in milder forms of erectile dysfunction





*Clinically, the optimal population of men with ED who will benefit most from TRT is unclear. There were inconsistent results on the impact of age on treatment efficacy and while multiple RCTs have focused on just older men, a parallel large study on younger men is still lacking. The threshold of ED and T deficiency severity for which TRT is efficacious, the dosing of TRT, the timing for initiating combination therapy, and the duration of the treatment have yet to be outlined in clinical guidelines. Presumably, TRT monotherapy could be first-line for patients with severe T deficiency but milder forms of ED (with PDE5i as salvage therapy if the response is poor), whereas a combination of TRT and PDE5i would be first-line for those with severe T deficiency and severe ED.





*It is important to recognize that, whatever outcome is considered, the effects of TRT are clearly evident only in the presence of hypogonadal status (ie, total T < 12 nmol/L), whereas the positive effects of TRT are no longer confirmed for higher T levels. In addition, TRT alone can be effective in restoring only milder forms of ED, whereas combined therapy with other drugs is required when more severe vascular damage is present.
 

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