Male Libido Disorders: Medical History

The case history (medical history) represents an important component in the diagnosis of male libido disorders. Family history

Social history

• What is your occupation?
• Is there any evidence of psychosocial stress or strain due to your family situation?
• Do you suffer from any psychological conflict?
• Do you have contact disorders?
• Do you have sexual inclinations that deviate from the norm?
• Do you suffer a lot from libido disorders?
• How does your partner assess the situation?
• How were you brought up? Were there any taboo subjects in your upbringing?
• How is/was your relationship with your parents?
• Do you have problems connecting with other people?

Current medical history/systemic history (somatic and psychological complaints).

• When does the disorder occur? Always or only in certain situations (place, certain partner)?
• Is sexual intercourse possible?
• What is the maximum level of arousal?
• Do you have nocturnal or morning erections?
• How often did you have sexual intercourse in the past? And how often today?
• Do you experience premature ejaculation (ejaculatio praecox)?
• Do you have an erection during masturbation?

Vegetative anamnesis including nutritional anamnesis.

• Do you smoke? If yes, how many cigarettes, cigars or pipes per day?
• Do you drink alcohol? If yes, what drink(s) and how many glasses per day?

Self history incl. medication history.

• Pre-existing conditions (diabetes mellitus, cardiovascular disease, liver disease, kidney disease, thyroid disease, other hormonal disorders, mental disorders).
• Operations
• Allergies

Medication history

• Antidepressants
  • Selective serotonin reuptake inhibitors (SSRIs, selective serotonin reuptake inhibitors) – citalopram, escitalopram, fluvoxamine, fluoxetine, sertraline.
• Antihypertensives
  • Angiotensin II antagonists (synonyms: AT-II-RB; ARB; angiotensin II receptor subtype 1 antagonists; AT1 receptor antagonists, AT1 antagonists; angiotensin receptor blockers (ARB), “sartans“) – candesartan, eprosartan, irbesartan, losartan, olmesartan, telmisartan, valsartan.
  • Beta blockers (atenolol, betaxolol, bisoprolol, carvedilol, celiprolol, metoprolol, nadolol, nebivolol oxprenolol, pindolol, propranolol
  • Clonidine
  • Methyldopa
  • Reserpine
• Antipsychotics (neuroleptics)
• Anxiolytics
• Hair restorer (finasteride)
• Lipid-lowering agent
  • Clofibrates (bezafibrate, fenofibrate, gemfibrozil).
• Gastrointestinal therapeutics (cimetidine, metoclopramide).
• Prostate drugs (finasteride, dutasteride).
• Psychoanaleptics
• Sympathomimetics
• Tranquilizers
• Cytostatic drugs (estramustine, methotrexate, Revlimid)

The following agents or groups of agents can trigger hyperprolactinemia and thus lead to libido and potency disorders in men:

• Adrenaline
• Angiotensin II
• Antiarrhythmic drugs (verapamil)
• Antidepressants
  • MAO inhibitors (moclobemide, rasagiline, selegiline, tranylcypromine).
  • Selective serotonin reuptake inhibitors, SSRIs (selective serotonin reuptake inhibitors) (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline).
  • Tricyclic antidepressants (amitryptiline, amitriptyline oxide, clomipramine, desipramine, dopexin, imipramine, maprotiline, nortriptyline, opipramol, tranylcypromine, trimipramine).
• Antiemetics (domperidone, metoclopramide).
• Antihistamines (synonyms: histamine receptor blockers or histamine receptor antagonists).
• Antihypertensives (clonidine, methyldopa).
  • Calcium channel blockers (amlodipine, dilitiazem, nifedipine))
• Antipsychotics (neuroleptics).
  • Conventional (Classical) antipsychotics (neuroleptics).
    • Butyrophenones – benperidone, fluspirilene, haloperidol, melperone, pipamperone.
    • Tricyclic neuroleptics
      • Phenothiazines (chlorpromazine, fluphenazine, levomepromazine, perazine, perphenazine, promethazine, thioridazine).
      • Thioxanthenes (chlorprothixene, flupentixol, zuclopenthixol).
  • Atypical antipsychotics (neuroleptics).
    • Benzamides – sulpiride
    • Benzisoxazole piperidine – risperidone
    • Dibenzodiazepines – olanzapine, quetiapine
• Antisympathotonics (reserpine).
• Endogenous opiates (endorphins)
• Endorphin
• Hormones
  • Antiandrogens (cyproterone acetate)
  • GnRH
  • Melatonin
  • Estrogens
  • TRH
  • TSH-releasing hormone (synonyms: thyroid-stimulating hormone, thyrotropin).
• H2 receptor blockers (cimetidine, ranitidine).
• Opioids (hydromorphone, morphine).
• Oxytocin
• Psychotropic drugs (phenothiazines, thioxanthenes).
• Serotonin
• Vasopressin