RSD Puzzle #091

H. Hooshmand, M. D.

DIPLOMATE AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY

BOARD CERTIFIED IN ELECTROENCEPHOLOGRAPHY

BOARD CERTIFIED IN ELECTROMYOGRAPHY

BOARD CERTIFIED IN AMERICAN BOARD OF ELECTODIAGNOSTIC MEDICINE

INTRACTABLE NEUROLOGY

EPILEPSY, PAIN, MS

An International Referral Center dedicated to Treatment, Education and Research

RSD PUZZLE #91
RSD, Opioids and Sex

You have asked if sex is good for RSD or not. Sex is very beneficial for RSD. RSD is a disturbance of the sympathetic system, the immune system, and the hormonal system of the brain. The sympathetic system regulates the immune system. The tools in this regulation consist of the white blood cells and their protective function, hormones such as ACTH, sex hormones, growth hormones and endorphins, as well as monoamine such as norepinephrine, serotonin, and acetylcholine.

Exercise, sex, rest and relaxation improve the function of the above mentioned immune system.

On the other hand, stress of any form, be it emotional or physical, traumatic or due to infection or toxins such as alcohol or narcotics, disrupt the function of the immune system.

In RSD natural and pleasant sex raises the threshold of pain because it also elevates sex hormones, endorphins and growth hormone. On the other hand, high doses of pain medication, especially the opioid agonist type of medication flood the hormonal system of the brain. Physical trauma such as unnecessary surgical procedures also causes the same adverse effect.

Among other benefits of a proper, natural sexual relationship, is the excellent natural REM sleep that ensues the sexual activity. The REM is essential for regeneration of the monoamine such as serotonin, which is an excellent anti-depressant, and Dopamine, which is an important monoamine in protection against stress.

Large doses of opioid agonist pain medications causes lack of desire for sex, as does an overdose with serotonin. Such an overdose of Serotonin at the cerebral level is a byproduct of SSRI anti-depressants such as Prozac, Paxil or Zoloft. This is the reason for lack of libido in over 1/5 the patients who take SSRI anti-depressants, such overdose can be corrected by periodic "drug holiday" such as stopping the SSRI intake on Friday, Saturday and Sunday and restarting it on Monday. Lack of libido is not just a lack of luxurious desire, but also the sign that other hormonal system and monoamine system are dysfunctional as well.

In the late stages of RSD (stages III and IV ), especially after surgical procedures or after insertion of infusion pump or spinal stimulator, there is such as suppression of sex hormones in the brain and spinal cord that two phenomena are noted. One is tenacious lack of libido, erection, and any other form of desire for sex. Another is the problem of severe fatigue and depression. Both of these problems can be corrected in men by testosterone replacement and in women by estrogen replacement. As a matter of fact, the infusion pump patient almost invariably require such hormonal replacement. Without the hormonal replacement, the depression and fatigue aggravate the chronic pain and result in failure of beneficial pain relief.

H. Hooshmand, M.D.

The material on the Neurological Associates Pain Management Center Homepage and all it's associated, linked or reference pages is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician. H. Hooshmand, M.D., Neurological Associates Pain Management Center and Associates will not be held liable for any damage or loss as a result of information provided on this page or associated documentation. Again, this WEB SITE is simply published as an information source and should not be used to treat or make judgments on RSD/CRPS. All associated material on this web site may not be copied, reproduced or quoted without expressed written permission from the owner; Copyright © 1999-2006 H. Hooshmand, M.D.