LDN Social Media
Get connected with us on social networks
Erectile Dysfunction Therapies - Yusuf, Saleeby, MD (2021 Conference) (LDN, low dose naltrexone)
Dr. Yousef Saleeby is a functional medicine physician practicing in North and South Carolina. He also is the director of a nonprofit 501c3 teaching academy called Priority Health Academy; and a medical director for the Carolina Holistic Medicine Centers. He also is a member of the Medical Advisory Board for the LDN Research Trust.
Dr. Saleeby tackles the topic of naltrexone and erectile dysfunction (ED), with a focus on understanding the research and lack thereof behind naltrexone and ED. He also reviews how LDN may be helpful in ED, the theoretical, physiological, and biochemical effects of LDN and naltrexone on erectile dysfunction, and the best delivery systems.
Published Research:
The first study used 50mg of naltrexone for ED, “Endorphins in Male Impotence: Evidence for Naltrexone Stimulation of Erectile Activity in Patient Therapy” published in Psycho Neuro Endocrinology back in 1989. Though we can take away some things from these cases even if it didn’t use LDN and is an older study. In this study with 30 male participants from 25-30 years of age, the naltrexone therapy significantly increased the number of successful coituses compared to placebo, after 7 and 15 day treatments. The positive effects of the drug on sexual behavior and erectile function were exerted in a central level, not with the hormones.
Another study is from 1993, in the Journal of Andrology, “Treatment of Idiopathic Erectile Dysfunction in Men with Opiate Antagonist Naltrexone-A Double Blind Study.” We again see the use of higher doses of naltrexone in this case, the doses of 25mg and 50mg. The study looked at the treatment of idiopathic erectile dysfunction in men with naltrexone. It is known that opioid antagonists can indirectly stimulate the secretion of luteinizing hormone and testosterone, as well as sexual functions in both animal and human models. In this study, 20 otherwise healthy men with idiopathic non organic erectile dysfunction, with an average age of around 46, were entered in this double blinded study with naltrexone or placebo. The group treated with naltrexone showed a significant rise in spontaneous early morning erections during treatment. The placebo group showed no significant change in spontaneous erections. The subjective parameters however, such as libido, degree of erection, and frequency of sexual intercourse, showed no significant difference within each group. There was again no difference in LH, FSH and testosterone concentrations in both groups. Therefore, it was determined that treatment with naltrexone significantly raises the rate of spontaneous early morning erections when compared to controls.
In a more recent study, from 2001, “Naltrexone-Induced Augmentation of Sexual Response in Men” published in the Archives of Medical Research. This was a double blind crossover design study using 25mg of naltrexone each day. This study provides evidence of endogenous opioid modulating orgasmic response, and the perceived intensity of sexual arousal and orgasm. An orgasm in men can be achieved with naltrexone, and at a dose of 25mg. it is useful in inhibited sexual desire and ED.
Clinical Observations:
Dr. Saleeby has followed the work of Dr. Mark Shukhman, who is a psychiatrist who practices in Ohio, who has a focus on sexual dysfunction in both male and female patients. He presented at the 2016 LDN Conference on the use of naltrexone for sexual function. Through his practice experience, Dr. Shukhman theorizes that LDN, when dosed very close to the time of expected intercourse, may possibly have a beneficial effect with regards to dopamine levels, and the prolactin and oxytocin levels as well. This would be helpful in arousal, and a potent aid to erectile dysfunction, but also beneficial in reducing the post-coital depressive state. Dr. Saleeby notes that this is all theoretical, as it’s never been tested because there's no research money to go and do a large clinical trial to test it. Because LDN has been established as an anti-inflammatory, this, too, may help improve sexual function, because inflammation actually can help increase erectile dysfunction in men.
With the theory that timed low dose naltrexone, right before intercourse, is the optimal time to administer it, there are certain delivery systems that are better than others, such as through a nasal spray for a more rapid delivery, and can be kept at bedside for easy use. There are compounding pharmacies that will prepare 1% solution of naltrexone for delivery via the nasal mucous membranes. Another possible delivery system would be to have a compounding pharmacy add 1% LDN to their tradition arousal cream or gel (scream cream) which they make for both men and women.
Case Studies from his Current Practice
A 55-year-old gentleman with a history of essential hypertension and fairly well controlled Type II diabetes. His past medical history is noteworthy for a kind of slow, insidious onset of erectile dysfunction which is mild, as well as decrease in performance during sexual intercourse, and decrease in libido. At LDN 3.5mg, the patient noted spontaneous morning penile tumescence had returned, there was more libido and actually better performance during intercourse with a spouse.
A 68-year-old gentleman with a history of hypothyroidism. He is very healthy and very conscious of his health and diet. LDN, started at 1mg and titrated to 2mg, which he's currently taking in the evenings. The patient told Dr. Saleeby that he feels like he's 20 years old again. He is having a definite benefit from LDN in all aspects of his health, not just erectile function, making him feel more youthful.
Dr. Saleeby points out that there's definitely a paucity of published studies and even clinical experience documenting the use of LDN in erectile dysfunction and sexual dysfunction. He and Dr. Shukhman would like any data that others are collecting on LDN in treating ED/SD so that they can start compiling some good data to support the use of LDN and maybe even spark a larger trial. He gives access to the IIEF-5 Questionnaire (short form) and the ED Questionnaire (long form) for use in collecting data. Contact Dr. Saleeby drsaleeby@carolinaholisticmedicine.com Phone: 800-965-8482 Fax: 888-242-0735
KEYWORDS: naltrexone, LDN, low dose naltrexone, erectile function, ED, erectile dysfunction, orgasm, erections, endorphins, libido, testosterone, sexual dysfunction, intercourse, sex, sexual function, nasal spray, scream crea