Men’s Sexual Health

The natural aging process and decline in testosterone levels by about 1.5% each year from age 30 on may cause low sex drive in men. A man’s physical health, emotional well-being, stress levels, and lifestyle may all contribute to low libido, as well. Men with diabetes, high blood pressure, sleep disorders, or anxiety and depression may also find that they think about and desire sex less than usual. Alcohol and drug use can also cause low sex drive in men, and tobacco use may damage blood vessels and suppress testosterone levels over time.

Lifestyle changes, such as improving sleep habits, reducing stress, regular exercise, and eating a healthy diet may help increase sex drive in men. However, low testosterone levels don’t replenish themselves; they only continue to decline naturally with age. For men in andropause, bioidentical hormone replacement therapy (BHRT) that includes a combination of testosterone, DHEA, and even oxytocin, may help boost male sex drive long term.

Belmar Pharmacy offers a variety of dosage forms and customizable strengths for medications that address men’s sexual dysfunction. Bioidentical hormone replacement therapy (BHRT) is available in the form of oral medications, topical creams, and injectable combinations. Oral medications like sildenafil citrate, vardenafil, and tadalafil, are designed to help men get and maintain an erection for satisfying sexual intercourse. Injectable testosterone therapies help increase hormone levels, and intracavernosal injections are injected directly into the penis to produce a more immediate result than other types of sexual dysfunction medications.

Hormone pellets are a unique delivery form created to replicate how hormones are naturally released in the body as closely as possible. In a simple office procedure, these rice-grain-sized pellets are inserted under a patient’s skin near the hip area.

Delivering hormone replacement therapy in pellet form has multiple benefits:

• Convenience: No need to worry about remembering to take daily medication. Hormone pellets may only need to be inserted 3 to 4 times per year.
• Minimal side effects: Pellet therapy sends hormones into the bloodstream, avoiding potential side effects of oral medications.
• Consistency: Pellets are designed to supply a consistent level of hormones in the bloodstream.

Bioidentical hormones, like the ones Belmar Pharmacy compounds, are used to treat men (and women) with low hormone levels. Bioidentical hormone pellets have the same molecular structure as natural human hormones, so they work the same way and are readily absorbed by the body.

Replenishing testosterone through pellets may improve men’s sexual wellness, including increasing libido and helping with erectile dysfunction.

A medical provider will likely begin by asking questions about current symptoms, as well as a medical and sexual history. Given the topic, the questions will get personal, but don’t sink into embarrassment. Answering truthfully is important.

A physical exam can follow that could include an examination of the penis and testicles, a rectal exam to check the prostate, a blood pressure check, as well as blood tests for hormone levels, blood sugar, and cholesterol. Depending on the results, the prescriber may recommend medication(s) or coordinate a consultation from a specialist such as a urologist, endocrinologist, sex therapist, or other counselor to address any underlying physical or psychological problems.

Testosterone levels drop roughly 1% each year after age 30, for many men. This can lead to lower libido and a decrease in nitric oxide (N.O.) production, which is needed for an erection.

But low testosterone may only play a small role in ED. Testosterone is connected to a man’s desire for sexual activity (libido), which in turn triggers dopamine and oxytocin release from the brain to increase N.O. for an erection. In most cases there are other underlying causes for ED. As patients get older, disease states are often the primary culprit for ED, with decreased testosterone being just one contributing factor.

Many conditions can be connected to ED, such as diabetes, high blood pressure, depression, high cholesterol, and cardiovascular disease. These health issues affect blood flow, nitric oxide production, and nerve signaling necessary to stimulate an erection. Improving the underlying causes that relate to erectile dysfunction, may also help restore sexual function. If the patient is generally considered healthy and ED is the only complaint, it’s a sign to the provider to look deeper for cardiovascular issues. ED can be a precursor to cardiovascular events down the road.

Patients with an increased risk of priapism – erections lasting 4 hours or more – should seek medical advice before starting injectable medications for erectile dysfunction. Conditions like sickle cell disease, leukemia, and multiple myeloma can be predisposed to priapism and are encouraged to discuss appropriateness of therapy with a provider. Use is contraindicated for those with Peyronie’s disease, bleeding disorders, or recurrent priapism.

Patients with higher likelihood for priapism should also discuss risk management, such as rescue medications, for emergent situations. Injectable phenylephrine can serve as a therapeutic option for these cases.

There are other conditions that may affect candidacy for compounded erectile dysfunction injectable medications. Reach out to a medical provider to discuss appropriate therapies.

Prescription drugs such as antidepressants, high blood pressure medicines, or antihistamines, may cause or worsen sexual dysfunction symptoms. If there are concerns that current medications may be negatively affecting sexual wellbeing, contacting a medical professional is recommended.

Low sex drive in men is especially common during andropause. Compounded hormone replacement therapy (HRT) can target libido changes and support sex drive. Consultations with a compounding pharmacist will explain the hormonal challenges of advancing age and share therapeutic options, like testosterone and oxytocin.

Low sex drive and erectile dysfunction can both be consequences of aging and andropause, but they are not the same thing. Having low sex drive means experiencing little to no desire for sex, whereas erectile dysfunction is difficulty achieving or maintaining an erection sufficient for sexual intercourse.

They can be connected, though. As men get older, hormone levels begin to drop. For many men, testosterone levels drop roughly 1% each year after age 30. This can lead to lower libido and a decrease in erectile function.

Low sex drive can happen at any time and it’s easy to misplace blame. Both women and men can experience it, though embarrassment and shame can prevent partners from talking about it. The goal is to build intimacy and foster connection so couples can address low sex drive together, whether the cause is psychological or physiological (or both).