From the Guidelines
To improve sex drive in a 40-year-old male, clinicians should discuss whether to initiate testosterone treatment with sexual dysfunction who want to improve sexual function, as suggested by the American College of Physicians (ACP) 1. When considering treatment options, it's essential to evaluate the potential benefits, harms, costs, and patient's preferences.
- The ACP recommends discussing testosterone treatment in men with age-related low testosterone and sexual dysfunction who want to improve sexual function 1.
- Testosterone treatment can be initiated with intramuscular formulations, which have similar clinical effectiveness and harms compared to transdermal formulations but are considerably lower in cost 1.
- Clinicians should reevaluate symptoms within 12 months and periodically thereafter, and discontinue testosterone treatment if there is no improvement in sexual function 1.
- Lifestyle modifications, such as regular exercise, stress reduction techniques, adequate sleep, and a balanced diet, can also help improve sex drive.
- Additionally, addressing psychological factors, such as relationship issues or seeking therapy, may also be beneficial in improving libido.
- Certain medications, like antidepressants, can decrease sex drive, so discussing medication adjustments with a doctor may be necessary.
- Supplements like zinc, vitamin D, or herbal options such as maca root or ashwagandha may also be considered, but their effectiveness and safety should be evaluated on an individual basis.
From the FDA Drug Label
Cyclic GMP causes smooth muscle relaxation and increased blood flow into the corpus cavernosum. The inhibition of phosphodiesterase type 5 (PDE5) enhances erectile function by increasing the amount of cGMP. Tadalafil inhibits PDE5 Because sexual stimulation is required to initiate the local release of nitric oxide, the inhibition of PDE5 by tadalafil has no effect in the absence of sexual stimulation.
To improve sex drive in a male 40 years old, tadalafil may be effective in improving erectile function. The medication works by increasing the amount of cGMP, which causes smooth muscle relaxation and increased blood flow into the corpus cavernosum. However, it is essential to note that sexual stimulation is required to initiate the local release of nitric oxide, and the inhibition of PDE5 by tadalafil has no effect in the absence of sexual stimulation.
- The recommended dosage of tadalafil is 10 mg or 20 mg, taken as needed, up to once per day 2.
- Tadalafil was shown to be effective in improving erectile function in men with erectile dysfunction (ED) in several clinical trials 2.
- The treatment effect of tadalafil did not diminish over time 2.
It is crucial to consult a healthcare professional before taking any medication, especially if you have any underlying medical conditions or are taking other medications.
From the Research
Improving Sex Drive in Males
To improve sex drive in males, particularly those around 40 years old, it's essential to consider the role of testosterone. Testosterone replacement therapy (TRT) is a common approach for addressing low testosterone levels, which can impact libido.
Testosterone Replacement Therapy (TRT) Options
Several TRT options are available, each with its benefits and limitations:
- Parenteral testosterone esters (enanthate and cypionate) administered every 2-3 weeks 3
- Parenteral testosterone undecanoate, which can maintain normal plasma testosterone levels for 12 weeks 3
- Subcutaneous testosterone implants, providing normal plasma testosterone for 3-6 months 3
- Transdermal testosterone preparations, such as gels, which offer flexible dosing and are recommended for elderly males 3
- Oral testosterone undecanoate formulations, like JATENZO and TLANDO, which have recently been approved by the US Food and Drug Administration 4
Considerations for TRT
When considering TRT, it's crucial to:
- Involve the patient in the selection of the testosterone preparation to ensure compliance 3
- Monitor treatment to minimize risks, particularly in older men with a history of heart failure 5
- Individualize treatment based on the patient's unique characteristics and needs 6
Comparison of TRT Modalities
A study comparing intramuscular testosterone cypionate (IM-TC) and subcutaneous testosterone enanthate autoinjector (SCTE-AI) found that both treatments increased total testosterone levels, but SCTE-AI was associated with lower levels of estradiol and hematocrit 7