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Author: Admin | 2025-04-28
That is, via subcutaneous or intramuscular injection.[30][32][35][36][37] At the same time, nafarelin is an exception in which its prescription is a nasal spray, and some may be implanted into fats.[31] In general, their half-lives are approximately two to four hours.[31][35][36][37] Some agonists are mainly excreted via urine while other agonists are mainly excreted via faeces.[31][35][36][37]Steroidal anti-androgens (Cyproterone acetate)[edit]Chemical structure of cyproterone acetate.Steroidal anti-androgens are a class of steroid drugs that inhibit the actions of androgens. Cyproterone acetate, a 17-hydroxyprogesterone acetate derivative, is a very potent one and is widely used.[29] Though it is not approved by the US FDA owing to its toxicity, it has been approved by Canada and a plethora of countries in Europe with the brand name Androcur in the market.[29][38][39] This drug mainly targets men due to its mechanism of action.Cyproterone acetate suppresses libido by directly reducing the level of active androgen, testosterone, in males. The suppression of testosterone level results from its inhibition of the release of luteinizing hormone (LH) from the anterior section of the pituitary gland, interfering with testosterone production from the testes as LH stimulates testosterone production.[32][39][40] It also blocks the conversion of testosterone to dihydrotestosterone for action.[38][41] In addition to this mechanism, it also competes for the androgen receptors against testosterone and dihydrotestosterone, causing interference with the androgen-receptor interaction on the reproductive organ, thereby lowering sexual desire.[29][38][41]Cyproterone acetate has been proven effective in restraining sexual drive and fantasies in patients with high libido.[5] Its usage in treating hypersexuality has been advocated by the World Federation of Societies of Biological Psychiatry (WFSBP).[5]Common adverse effects of cyproterone acetate include depression, hepatotoxicity, dyspnea, change in body weight, hot flushes, sweating, fatigue, and gynaecomastia.[29][39]Cyproterone acetate is mainly orally administered to the body, and it has a half-life of 1.8 days.[29][39][42] After metabolism, its metabolites are predominantly excreted via faeces.[39]There are many types of drugs that unintentionally lower sexual desire through indirect mechanisms. It is one of their side-effects as the outcome of libido suppression is not intended. However, selective serotonin reuptake inhibitors (SSRIs), being one of them, are indeed often prescribed to people who have immense sexual desire. SSRIs reduce the re-uptake of serotonin back to the neurons, leading to an increase in serotonin level in the body. Due to the fact that serotonin can interfere with other neurotransmitters and hormones, for instance, sex hormones, SSRIs can therefore lower sexual desire.[43]Apart from SSRIs, other types of drugs that could lower sexual desire are not intended to suppress libido originally. Thus, sexually active people are suggested to avoid the usage of the following drugs:[44]Antihypertensive drugsAnti-anxiety drugs (e.g. benzodiazepines)Antipsychotic drugsAnticonvulsantsNon-steroidal anti-inflammatory drugs (e.g. Antihistamine)OpioidMedical marijuanaRecreational drugsPostmenopausal women may also suffer from HSDD due to a decline in androgen production from menopause.[6] A research proposed two combinations of drugs, each designed against the different causes of HSDD. One combination is to utilise sublingual testosterone with a 5-HT1A receptor agonist to raise motivation for sex, by lifting the inhibition mechanisms in the brain's prefrontal regions.[6][7][8] Testosterone is also proposed
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