Benzodiazepine use and low Testosterone

[skywalker45]

Benzodiazepine use and low Testosterone

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I’d like Dr. M’s opinion too if at all possible. I’m trying to find a link between long term use of high potency benzodiazepines and low T or at least symptoms of low T. I’ve been taking Klonopin 1.5mg a day for about 7 years for acute anxiety. In retrospect it was probably always the hypogonadism that caused the anxiety in the first place but I still can’t help but wonder how much of my problem could be pharmacologically induced. I’m going to discuss this in depth with my new doctor and see about going off Klonopin. The worst part of going off it after all these years is the dependence that I have on it. I’m really worried the physical withdrawal is gonna be hell. Any opinions from you guys? Dr. M?

Also I’d like to go off the Klonopin. What would be a suggested tapering schedule at this dosage after all these years?

[DrMariano2]

@skywalker45 1403 wrote:

Benzodiazepine use and low Testosterone

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I’d like Dr. M’s opinion too if at all possible. I’m trying to find a link between long term use of high potency benzodiazepines and low T or at least symptoms of low T. I’ve been taking Klonopin 1.5mg a day for about 7 years for acute anxiety. In retrospect it was probably always the hypogonadism that caused the anxiety in the first place but I still can’t help but wonder how much of my problem could be pharmacologically induced. I’m going to discuss this in depth with my new doctor and see about going off Klonopin. The worst part of going off it after all these years is the dependence that I have on it. I’m really worried the physical withdrawal is gonna be hell. Any opinions from you guys? Dr. M?

Also I’d like to go off the Klonopin. What would be a suggested tapering schedule at this dosage after all these years?

I doubt a clear relationship between hypogonadism and the use of Clonazepam.

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Here is one on how benzodiazepine treatment prevents testosterone from decreasing as a result of stress.

Andrologia. 2006 Oct;38(5):159-65
Diazepam administration prevents testosterone decrease and lipofuscin accumulation in testis of mouse exposed to chronic noise stress.
Ruffoli R, Carpi A, Giambelluca MA, Grasso L, Scavuzzo MC, Giannessi F F.

Lipofuscin is an autofluorescent and undegradable material, which accumulates in tissues during ageing and under different types of stress. Among these, oxidative stress represents a major trigger for lipofuscin formation. However, prolonged noise exposure is also an effective stressful stimuli. Diazepam may inhibit lipofuscinogenesis in liver and prevent the noise-induced reduction of the steroidogenesis in the adrenal gland. The aim of the study was to ascertain whether chronic noise exposure causes lipofuscin accumulation in mouse testis, and to evaluate the effects of diazepam administration. Eight-week old mice were either exposed for 6 weeks (6 h day(-1)) to white-noise (group A), or received diazepam (3 mg kg(-1), i.p.) before noise exposures (group B), while a further group was used as control (group C). Light fluorescence and transmission electron microscopy revealed lipofuscin in large amounts in the Leydig cells in mice of group A, which concomitantly had low serum testosterone levels; pre-treatment with diazepam occluded both effects. The present study indicates that: (i) chronic noise exposure causes lipofuscin accumulation at the level of the Leydig cells and a decrease in testosterone; (ii) all these effects are suppressed by pre-treatment with diazepam. As the Leydig cells represent the only cellular type of the interstitial testicular tissue having peripheral benzodiazepine receptors, these results could be explained by the capacity of the peripheral benzodiazepine receptors to prevent reactive oxygen species damage and to increase the resistance of these cells to oxidative stress.

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Another one: benzodiazepine treatment had no effect on testosterone production.

Bull Exp Biol Med. 2005 Dec;140(6):658-63.
Effect of diazepam on anxiety, sexual motivation, and blood testosterone in anxious male mice.
Amikishieva AV, Semendyaeva SN.

The effects of diazepam on anxious behavior, sexual motivation, and blood level of testosterone in the presence of a female were studied in male mice with elevated anxiety. Diazepam produced an anxiolytic effect in novel environment, but was ineffective during social contacts. The drug potentiated the primary sexual interest, but failed to correct exhaustion of sexual motivation. The drug produced no effect on blood testosterone.

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[skywalker45]

That’s good to hear doctor and thank you for the reply and the other information. I do believe however, and please correct me if I’m wrong, that Clonazepam and other benzos can and do cause loss of interest in sex, ED and ejaculation problems. I thought the connections there were a little more clear or am I wrong there?

[DrMariano2]

@skywalker45 1421 wrote:

That’s good to hear doctor and thank you for the reply and the other information. I do believe however, and please correct me if I’m wrong, that Clonazepam and other benzos can and do cause loss of interest in sex, ED and ejaculation problems. I thought the connections there were a little more clear or am I wrong there?

Benzodiazepines, such as Clonazepam, increase GABA signaling. The increase in GABA signaling can reduce norepinephrine signaling (the signal that causes anxiety and irritability and insomnia, etc.)

Norepinephrine is necessary (though not in excess) for libido, erectile function (providing the excitement of sex), and ejaculation (it triggers ejaculation).

Excessively reducing norepinephrine can cause problems with the above functions.

[skywalker45]

@DrMariano 1423 wrote:

Benzodiazepines, such as Clonazepam, increase GABA signaling. The increase in GABA signaling can reduce norepinephrine signaling (the signal that causes anxiety and irritability and insomnia, etc.)

Norepinephrine is necessary (though not in excess) for libido, erectile function (providing the excitement of sex), and ejaculation (it triggers ejaculation).

Excessively reducing norepinephrine can cause problems with the above functions.

Wow then I’ve really been playing with fire. To top off all that I also take propranolol 40mg/day and have for about 17 years. Not for HBP though. It was given to me for tachycardia potentiated by severe panic attacks. No one ever took me off the medication because they all said at such a low dose it wouldn’t matter and it’s heart protective, but it blocks adrenergic receptors and in my line of thinking since I’ve aged some this drug could also be causing many of my problems now. I should note that I never had a problem with ED, ejaculation or sexual desire before age 36 (I’m 40 now). I would have been on propranolol for 13 years before any sexual problems (I believe related to hypogonadism) began to occur.

[hardasnails1973]

Wouldn’t treating the brain inflammation from depression help to go along way to reducing ones symptoms or further damage to the CNS There was a study done to show that depressed people tend to have a greater demand for antioxidents then non depressed people. The process by which you mentioned lipofuscin is that the same process by which age spots are formed? Vitamin E is also needed to help reduce this process with in the brain, liver and also the eyes.

http://www.medscape.com/medline/abstract/6101134

Could depression also spawn from excessive oxidative stress with in the brain resulting from the depletion of proper antioxident reserves?
Could replenishing these proper levels resulting in alleviating the depression.
http://www.ncbi.nlm.nih.gov/pubmed/18580840

Amazingly people that when spectracell test are ran that test low in selenium are always low in Vitamin E as well?
Selenium and vitamin E have a huge interrelation but if one is low in selenium could this automatically result in decrease in bioavailability of vitamin E. Selenium is an over looked nutrient in men’s testosterone production. Vitamin E has also been noted to help LH to work more effectively in males. How this occurs is just through speculation that it may help in testosteorne signalling not at the tissue level, but at the pitutary level.

[DrMariano2]

@skywalker45 1424 wrote:

Wow then I’ve really been playing with fire. To top off all that I also take propranolol 40mg/day and have for about 17 years. Not for HBP though. It was given to me for tachycardia potentiated by severe panic attacks. No one ever took me off the medication because they all said at such a low dose it wouldn’t matter and it’s heart protective, but it blocks adrenergic receptors and in my line of thinking since I’ve aged some this drug could also be causing many of my problems now. I should note that I never had a problem with ED, ejaculation or sexual desire before age 36 (I’m 40 now). I would have been on propranolol for 13 years before any sexual problems (I believe related to hypogonadism) began to occur.

Beta-blockers such as Propranolol are very well known for decades for their ability to shut down libido and cause erectile dysfunction.

On family doctor I trained with told me it was often the wives of his male patients who would drag the patient in because of his lack of libido and erectile dysfunction on beta-blockers and other antihypertensives.

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