Post Date December, 03 2023
In fact, each sexual stage has an independent neuropharmacological mechanism, and the impact of different diseases and drugs on each stage is different. A correct understanding of the interrelationship between various drugs, diseases, and different stages of sexual function will help clinicians determine whether the patient's sexual dysfunction is caused by the disease or drugs, thereby achieving a reasonable treatment through some adjustment or compensation effect. This article focuses on summarizing the neuropharmacological mechanisms of different sexual stages and the effects of psychotherapy drugs and diseases on sexual function.
Sexual Stages and Neuromediators
The first stage (excitement period): related to sexual satisfaction and desire. Dopamine, testosterone, and estrogen have an excitatory effect on this phase, while prolactin has an inhibitory effect. The physiological mechanism of sexual activity begins in the central nervous system, and sexual arousal and pleasure seem to be caused by neural mediators in the "sexual pleasure center.". Dopamine can promote sexual excitement, while dopamine blockage can affect sexual function.
The second stage (duration): Men exhibit erections, while women exhibit lubrication and enlargement of their sexual organs. This stage is mainly controlled by 5-hydroxytryptamine and norepinephrine, and nitrogen oxides, acetylcholine, and estrogen play an exciting role in this stage. 5-hydroxytryptamine can reduce the release of central nervous mediators of sexual pleasure; On the other hand, 5-hydroxytryptamine blocks 5-hydroxytryptamine receptors through the spinal cord reflex center innervated by sympathetic and parasympathetic nerves, thereby preventing sexual intercourse and orgasm.
The third stage (orgasm): The female orgasm is characterized by the simultaneous rhythmic contraction of the uterus, orgasm platform (the outer third of the hyperemic uterus), and anal sphincter. Male orgasm is the period when their sexual response has the highest level of periodic excitement, and sexual pleasure peaks with orgasm. Norepinephrine has an excitatory effect on this phase, while 5-hydroxytryptamine has an inhibitory effect.
Effects of different diseases and drugs on different stages of sexual reaction
1. Excitement period: the influencing factors include depression, endocrine disorders (thyroid disease, diabetes, etc.), medical diseases, interpersonal problems, menopause, and estrogen status. This factor has a greater impact on men. Bupropionate, apomorphine, ritalin, cocaine, and amphetamine have excitatory effects on this period, while SSRI, antipsychotics, and atypical antipsychotics have inhibitory effects.
2. Duration: influencing factors include diabetes, hypertension, alcohol and drug abuse, obesity, smoking, depression, psychological and interpersonal problems, age, etc. These factors have a greater impact on women. Sildenafil, bupropion, prostaglandins, and apomorphine have an excitatory effect on this phase, while SSRI, anticholinergics, and alcohol have an inhibitory effect.
3. High tide period: the influencing factors include diabetes, neuropathy, depression, interpersonal problems, etc., and there is no significant difference between men and women. At this stage, apomorphine and sildenafil have excitatory effects, while SSRI and β Receptor blockers have an inhibitory effect.
