Hypoactive Libido: Neurohumoral Characteristics, Regions of the Brain Regulating Sexual Desire, and Its Reactions to Erotic Stimuli
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Abstract
The article indicates that sexual desire is considered to result from a complex balance between inhibitory and stimulating factors (neurotransmitters, hormones), which influence functioning of the brain. For example, dopamine, oxytocin, estrogens, noradrenalin, melanocortin, norepinephrine and testosterone produce excitory influence, while serotonin, endocannabinoiids, prolactin (PRL) and opioids produce inhibitory influence. The article contains data of researches, which informed about peculiarities in reactions of the brain in people with hypoactive sexual desire to erotic stimuli as well as sex differences of the above reactions to these stimuli. Also, key regions in the brain that regulate sexual desire (the prefrontal cortex, locus coeruleus, medial preoptic area, paraventricular nucleus, and reward- and attention-processing centers of the ventral tegmental area and the nucleus accumbens) are listed.
Information about hormonal regulation of sexual desire in men is given. The article informs about studies that are not consistent with the established view about an inhibitory influence of hyperprolactinaemia (HP) on sexual functions in men (G. Corona et al., 2007, 2014), whose authors, on the contrary, note that analysis of the relation between PRL level and sexual disorders revealed a strong correlation between lower PRL levels and reduced pleasure from orgasm. They also revealed that a low PRL level was associated with erectile dysfunction (ED) and early ejaculation. This phenomenon may be explained by the fact that the low PRL level was associated with bad health. G. Corona et al. (2007, 2014) insist that severe HP may be associated with ED only because of HP, which in its turn is caused by hypogonadal state. Moreover, and what is especially important for the problem in question, severe HP was associated with hypoactive sexual desire (HSD), an increased level of thyrotropin and hypogonadism. A relationship between severe HP and HSD was confirmed after correction of testosterone and thyrotropic hormone levels and use of psychotropic agents. The cited authors conclude that in compliance with their findings severe, rather than mild, HP is an important determinant of HSD. Nevertheless they believe that PRL can produce more positive than negative effects in initiating and maintaining sexual behavior.
Our article also discusses hormonal regulation of sexual desire in women. Though before it was supposed that adrenal androgens played a pivotal role for appearance of sexual desire in them, later an opinion formed that it was not so and the focus was shifted to ovarian corticosteroids, including estradiol and testosterone. It is noted that though ovarian corticosteroids can produce some effect on sexual desire in women, their exact role in the appearance of HSD disorder in females remains unclear.
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References
Izdatelstvo Anti-Age Expert. Vliyaniye estradiola na organizm [Internet]. Izdatelstvo Anti-Age Expert; 2021. Available at: https://antiage-expert.com/ru/blog/vliyanie-estradiola-naorganizm/.
Gladkova AI. Gormonalnaya regulyatsiya muzhskogo seksualnogo povedeniya: lektsiya dlya seksologov, seksopatologov, endokrinologov, urologov, fiziologov. Kharkov: UkrNIIFEZ; 1998. 17 p.
Gladkova AI. Muzhskiye polovyye funktsii pri giperprolaktinemii. Urol nefrol. 1987;4:71–4.
Kamyshnikov VS. Klinicheskiye laboratornyye testy ot A do YA i ikh diagnosticheskiye profili: sprav. posobiye. 3-ye izd. Moskva: MEDpress-inform; 2007. 320 p.
Kocharyan GS. Polovyye feromony cheloveka (noveyshaya seksologiya). Kharkov: KHNU im. V. N. Karazina; 2005. 270 p.
Priroda darit kholostyakam bol’she testosterona. Gazeta Sekretnyye issledovaniya. 2002;50(6):4.
Teppermen Dzh, Teppermen KH. Fiziologiya obmena veshchestv i endokrinnoy sistemy. Vvodnyy kurs: per. s angl. Moskva: Mir; 1989. 656 p.
Izdatestvo Helixbook. Testosteron svobodnyy [Internet]. Izdatelstvo Helixbook; 2011. Available at: https://helix.ru/kb/item/08-050.
Izdatelstvo Helixbook. Testosteron [Internet]. Izdatelstvo Helixbook; 2011. Available at: https://helix.ru/kb/item/08-117.
Vydavnytstvo Invitro. monitorynh. Testosteron [Internet]. Yzdatelstvo Invitro. monitorynh; 2013. Available at: https://www.invitro.ru/library/labdiagnostika/24566/.
Arnow BA, Millheiser L, Garrett A, Lake PM, Glover GH, Hill KR, et al. Women with hypoactive sexual desire disorder compared to normal females: a functional magnetic resonance imaging study. Neurosc. 2009;158(2):484–502. doi: 10.1016/j.neuroscience.2008.09.044.
Bancroft J, Graham CA, Janssen E, Sanders SA. The dual control model: current status and future directions. J Sex Res. 2009;46(2-3):121–42. doi: 10.1080/00224490902747222.
Benkert O, Witt W, Adam W, Leitz A. Effects of testosterone undecanoate on sexual potency and the hypothalamicpituitary-gonadal axis of impotent males. Arch Sex Behav. 1979;8(6):471–9. doi: 10.1007/BF01541414.
Bianchi-Demicheli F, Cojan Y, Waber L, Recordon N, Vuilleumier P, Ortigue S. Neural bases of hypoactive sexual desire disorder in women: an event-related FMRI study. J Sex Med. 2011;8(9):2546–59. doi: 10.1111/j.1743-6109.2011.02376.x.
Bitzer J, Geraldi A, Pfaus JG. Sexual desire and hypoactive sexual desire disorder in women: introduction and overview: standard operating procedure (SOP part 1). J Sex Med. 2013;10(1):36–49. doi: 10.1111/j.1743-6109.2012.02818.x.
Buvat J. Hyperprolactinemia and sexual function in men: a short review. Int J Impot Res. 2003;15(5):373–7. doi: 10.1038/sj.ijir.3901043.
Buvat J, Lemaire A, Buvat-Herbaut M, Fourlinnie JC, Racadot A, Fossati P. Hyperprolactinemia and sexual function in men. Horm Res. 1985;22(3):196–203. doi: 10.1159/000180094.
Cacioppo S. Neuroimaging of Female Sexual Desire and Hypoactive Sexual Desire Disorder. Sex Med Rev. 2017;5(4):434–44. doi: 10.1016/j.sxmr.2017.07.006.
Cappelletti M, Wallen K. Increasing women’s sexual desire: the comparative effectiveness of estrogens and androgens. Horm Behav. 2016;78:178–93. doi: 10.1016/j.yhbeh.2015.11.003.
Clayton AH. The pathophysiology of hypoactive sexual desire disorder in women. Int J Gynaecol Obstet. 2010;110(1):7–11. doi: 10.1016/j.ijgo.2010.02.014.
Corona G, Mannucci E, Fisher AD, Lotti F, Ricca V, Balercia G, et al. Effect of hyperprolactinemia in male patients consulting for sexual dysfunction. J Sex Med. 2007;4 (5):1485–93. doi: 10.1111/j.1743-6109.2007.00569.x.
Corona G, Wu FC, Rastrelli G, Lee DM, Forti G, O’Connor DB, et al. Low Prolactin is Associated with Sexual Dysfunction and Psychological or Metabolic Disturbances in Middle-Aged and Elderly Men: The European Male Aging Study (EMAS). J Sex Med. 2014;11(1):240–53. doi: 10.1111/jsm.12327.
Cruz-Casallas PE, Nasello AG, Hucke EE, Felicio LF. Dual modulation of male sexual behavior in rats by central prolactin: Relationship with in vivo striatal dopaminergic activity. Psychoneuroendocrin. 1999;24(7):681–93. doi: 10.1016/s0306-4530(99)00021-9.
Davis SR, Davison SL, Donath S, Bell RJ. Circulating androgen levels and self-reported sexual function in women. JAMA. 2005;294(1):91–6. doi: 10.1001/jama.294.1.91.
Dennerstein L, Burrows GD, Wood C, Hyman G. Hormones and sexuality: effect of estrogen and progestogen. Obstet Gynecol. 1980;56(3):316–22.
Dennerstein L, Randolph J, Taffe J Dudley E, Burger H. Hormones, mood, sexuality, and the menopausal transition. Fertil Steril. 2002;77(4):42–8. doi: 10.1016/s0015-0282(02)03001-7.
Drago F, Lissandrello CO. The “lowdose” concept and the paradoxical effects of prolactin on grooming and sexual behavior. Eur J Pharmacol. 2000;405(1-3):131–7. doi: 10.1016/s0014-2999(00)00678-6.
Everitt BJ. Neuroendocrine mechanisms underlying appetitive and consummatory elements of masculine sexual behavior. The Pharmacology of Sexual Function and Dysfunction. Amsterdam: Exerpta Medica; 1995, p. 15–31.
Georgiadis JR, Kringelbach ML, Pfaus JG. Sex for fun: bringing together human and animal neurobiology. Nat Rev Urol. 2012;9(9):486–98. doi: 10.1038/nrurol.2012.151.
Gettler LT, McDade TW, Feranil AB, Kuzawa CW. Prolactin, fatherhood, and reproductive behavior in human males. Am J Phys Anthropol. 2012;148(3):362–70. doi: 10.1002/ajpa.22058.
Goldstein I, Kim NN, Clayton AH, DeRogatis LR, Giraldi A, Parish SJ, et al. Hypoactive Sexual Desire Disorder: International Society for the Study of Women’s Sexual Health (ISSWSH) Expert Consensus Panel Review. Mayo Clin Proc. 2017;92(1):114–28. doi: 10.1016/j.mayocp.2016.09.018.
Hellhammer DH, Hubert W, Schürmeyer T. Changes in saliva testosterone after psychological stimulation in men. Psychoneuroendocrinol. 1985;10(1):77–81. doi: 10.1016/0306-4530(85)90041-1.
Karama S, Lecours AR, Leroux JN, Bourgouin P, Beaudoin G, Joubert S, et al. Areas of brain activation in males and females during viewing of erotic film excerpts // Human Brain Mapp. 2002;16(1):1–13. doi: 10.1002/hbm.10014.
Maurice WL. Male Hypoactive Sexual Desire Disorder. In: Balon R, Segraves RT, editors. Handbook of Sexual Dysfunction (Eds.). Boca Raton: Taylor & Francis Group; 2005, p. 67–109.
Gholipour B. Men’s sexual desire linked to prolactin levels [Internet]. Livescience; 2013. Available from: https://www.livescience.com/41322-low-prolactin-men-sexual-impairment.html.
Meuleman EJ, Van Lankveld JJ. Hypoactive sexual desire disorder: an underestimated condition in men. BJU Int. 2005;95(3):291–6. doi: 10.1111/j.1464-410X.2005.05285.x.
Modebe D. Serum Prolactin Concentration in Impotent African Males. Androl. 1989;21(1):42–7.
Nelson RJ. An Introduction to Behaviorial Endocrinology. 2nd edition. Sunderland, MA: Sinauer Associates; 2000. 127 p.
Nieschlag E. The endocrine function of human testis in regard to sexuality. In Ciba Foundation Symposium. Sex, hormones and behaviour. Amsterdam: Excerpta Medica; 1979, p. 182–208.
Nilsson P, Moller L, Solstad K. Adverse effects of psychosocial stress on gonadal function and insulin levels in middle-aged males. J Intern Med. 1995;237(5):479–86. doi: 10.1111/j.1365-2796.1995.tb00873.x.
O’Carroll R, Bancroft J. Testosterone therapy for low sexual interest and erectile dysfunction in men: a controlled study. Br J Psychiatry. 1984;145:146–51. doi: 10.1192/bjp.145.2.146.
Pfaus JG. Pathways of sexual desire. J Sex Med. 2009;6(6):1506–33. doi: 10.1111/j.1743-6109.2009.01309.x.
Pfaus JG, Ismail N, Coria-Avila GA. Sexual motivation. In: Koob GF, Le Moal M, Thompson RF, editors. Encyclopedia of Behavioral Neuroscience. 3nd edition. Oxford, England: Academic Press; 2010, p. 201–9.
Reis SL, Abdo CH. Benefits and risks of testosterone treatment for hypoactive sexual desire disorder in women: a critical review of studies published in the decades preceding and succeeding the advent of phosphodiesterase type 5 inhibitors. Clinics. 2014;69(4):294–303. doi: 10.6061/clinics/2014(04)11.
Salmimies P, Kockott G, Pirke KM, Vogt HJ, Schill WB. Effects of testosterone replacement in hypogonadal men. Arch Sex Behav. 1982;11(4):345–53. doi: 10.1007/BF01541595.
Sherwin BB, Gelfand MM. The role of androgen in the maintenance of sexual functioning in oophorectomized women. Psychosom Med. 1987;49(4):397–409. doi: 10.1097/00006842-198707000-00009.
Sherwin BB, Gelfand MM, Brender W. Androgen enhances sexual motivation in females: a prospective, crossover study of sex steroid administration in the surgical menopause. Psychosom, Med. 1985;47(4):339–51. doi: 10.1097/00006842-198507000-00004.
Simon JA. Low sexual desire – is it all in her head? Pathophysiology, diagnosis, and treatment of hypoactive sexual desire disorder. Postgrad Med. 2010;122(6):128–36. doi: 10.3810/pgm.2010.11.2230.
Stahl SM. Targeting circuits of sexual desire as a treatment strategy for hypoactive sexual desire disorder. J Clin Psychiatry. 2010;71(7):821–2. doi: 10.4088/JCP.10bs06117blu.
Wahlin-Jacobsen S, Pedersen AT, Kristensen E, Laessoe NC, Lundqvist M, Cohen AS, et al. Is there a correlation between androgens and sexual desire in women? J Sex Med. 2015;12(2):358–73. doi: 10.1111/jsm.12774.
Waxenberg SE, Drellich MG, Sutherland AM. The role of hormones in human behavior, I: changes in female sexuality after adrenalectomy. J Clin Endocrinol Metab. 1959;19(2):193–202.
Weizman A, Weizman R, Hart J, Maoz B, Wijsenbeek H, Ben DM. The correlation of increased serum prolactin levels with decreased sexual desire and activity in elderly men. J Am Geriatr Soc. 1983;31(8):485–8. doi: 10.1111/j.1532-5415.1983.tb05123.x.