ED

Question 1

What causes ED?

Answer 1

• Antihypertensives (thiazide diuretics, B-blockers, CCB) –> lack of arterial blood flow
• Antiandrogens (Ketoconazole, H2 receptor antagonists) –> Decrease in androgen
• Antiarrhythmics (digoxin, amiodarone, disopyramide) –> Inhibits testosterone to receptor
• Psychotropics

Question 2

Which neurotransmitter is responsible for erection?

Answer 2

Acetylcholine

Question 3

What medications can help with ED?

Answer 3

• PDE5 (tadalafil) –> Increased levels of cGMP which causes vasodilation
• Eroxon - localized cooling effect -> warming effect to stimulate nerve endings

Question 4

What medications can cause female sexual dysfunction?

Answer 4

• Antipsychotics
• Antidepressants
• Antiretrovirals
• Antihypertensives
• Antiepileptics

Question 5

How to treat female sexual dysfunction?

Answer 5

• filbanserin –> Decreases serotonin and increases dopamine and NE
• bremolanotide –> Melanocortin receptor agonist (MC1R - hyperpigmentation & MC4R - CNS)
• Oral or vaginal estrogen for dryness and discomfort
• Testosterone supplements
• DHEA
• SERMs
• Bupropion SR