Is your medication killing your sex drive?

"In the Mood" is more than a title to a Big Band-era hit. If you're dealing with low libido, you won't feel in the mood for sex as much as you did previously - and you might wonder what happened.

You may want to check your medicine cabinet. While low libido can stem from numerous causes, one that's often overlooked is medications. Many people don't realize that commonly used drugs can dampen their sex drive - which encompasses not just their desire for sex, but also how satisfying it is, according to a Harvard expert.

Feeding this lack of awareness, some physicians may not mention low libido as a treatment tradeoff. But it's perhaps also lower on the list of side effects people worry about when starting a new drug, says Dr. Lisa Baute, a gynecologist and menopause expert at the Midlife Women's Health Center at Harvard-affiliated Massachusetts General Hospital. "You might be more worried about other effects that could be caused by the medication," she says.

What drugs are on the list?

Medications can chip away at sex drive through many potential pathways, altering hormone levels or nerve signals, dulling sensation in the genitals, or triggering fatigue or mood changes.

It's an equal-opportunity issue, though women may encounter certain female-specific medications that can have this effect. Here's what to watch for:

• Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are among the most common medications tied to low libido, according to the CDC. More than 11% of Americans take antidepressants, and women are more than twice as likely as men to take them.
• Cardiovascular drugs such as beta blockers and diuretics, which treat high blood pressure or heart conditions, may reduce blood flow to the genitals and diminish sensation.
• Antihistamines are meant to dry out your sinuses, but may have the same effect on vaginal tissue, hindering arousal and making sex uncomfortable. Antihistamines can also make you sleepy.
• Antiseizure drugs such as phenytoin (Dilantin) or carbamazepine (Tegretol) can speed the breakdown of sex hormones in the liver, lowering sex drive.
• Opioids and other prescription pain medications can suppress hormones and cause fatigue and mood changes, hindering libido.
• Chemotherapy causes myriad physical, hormonal, and psychological effects on the body that can sap the desire for sex.
• Hormone blockers, oral contraceptives, and fertility drugs can all alter hormone levels, reducing libido, arousal, and pleasure.

Given the extensive list, a huge number of Americans are taking one or more of these drugs, Dr. Baute notes. But not everyone responds to a medication in the same way.

"This certainly could be affecting a large proportion of the population," she says. "But while it's a potential side effect, I don't think it's universal."

Tackling the problem

Drug effects on libido are typically long-term - reversible if you discontinue the medication, but lingering as long as you take it. With that in mind, anxiety and frustration are integral to the picture.

"That's often why people will bring up the issue with their doctor. It's causing stress in their relationship, and they want to know what they can do to fix it," Dr. Baute says. She suggests the following measures.

Ask about alternatives. Your doctor might be able to adjust your medication's dose or timing, or substitute another drug without sexual side effects. For example, the antidepressant bupropion (Wellbutrin) doesn't typically cause libido problems. "It's tough, though, right? Because if your antidepressant is working, it's definitely a balance between treating your symptoms and coping with unwanted side effects," says Dr. Baute.

Investigate nondrug approaches. Sexual health counseling or stress management techniques (such as meditation or deep breathing) can help ease emotional stress that hinders sex drive and quiet mental chatter that can block arousal.

Regardless, don't change your medication regimen without speaking to your doctor first. "There can be a lot of shame or embarrassment associated with this issue," Dr. Baute says. "But people shouldn't be afraid to approach their provider and explore causes of their symptoms so they can look for a solution that will improve their well-being."

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