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February 03, 2023
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Kisspeptin may enhance sexual arousal for men with hypoactive sexual desire disorder

Fact checked byRichard Smith
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Kisspeptin was associated with enhanced sexual brain processing, increased penile tumescence and multiple measures of sexual desires and arousal among men with hypoactive sexual desire disorder, according to a study data.

As Healio previously reported, IV kisspeptin was associated with brain processing of erotic stimuli and facial attractiveness among a cohort of premenopausal women with hypoactive sexual desire disorder. The latest data from researchers at Imperial College London similarly found kisspeptin can also provide benefits for men.

Benefits of kisspeptin for men with hypoactive sexual desire disorder.
Infographic content were derived from Mills EG, et al. JAMA Netw Open. 2023;doi:10.1001/jamanetworkopen.2022.54313.

The study was published in JAMA Network Open.

Alexander Comninos
Waljit S. Dhillo

“Distressing low sexual desire of unexplained cause affects up to 10% of women and men globally,” Alexander Comninos, MD, PhD, consultant endocrinologist at Imperial College Healthcare NHS Trust; and Waljit S. Dhillo, MD, PhD, a National Institute for Health and Care Research (NIHR) senior investigator from the department of metabolism, digestion and reproduction at Imperial College London and consultant endocrinologist at Imperial College Healthcare NHS Trust, told Healio. “Hence, it is a really significant problem in day-to-day life with detrimental effects on quality of life and relationships. Current licensed treatments in women have limited efficacy and significant side effects, and in men there are no licensed treatments. In these two studies we provide proof-of-concept that kisspeptin administration may be a very well-tolerated and effective treatment option for this significant problem. Given that kisspeptin can work in the sexual brain as well as have downstream effects on the penis in men, we are hopeful that this will be a breakthrough that we can take forward to ultimately help women and men with hypoactive sexual desire disorder.”

Researchers recruited 32 right-handed heterosexual men diagnosed with hypoactive sexual desire disorder (mean age, 37.9 years; 68% white) to participate in a double-blind, two-way, crossover randomized controlled trial. A battery of psychometric questionnaires and blood testing were conducted at baseline. Participants completed two study visits at least 7 days apart, with men receiving IV kisspeptin in one visit and placebo in the other visit. Blood samples were taken at 15-minute intervals beginning 30 minutes before the infusion and continuing until the end of the 75-minute infusion. Between 30 and 60 minutes of the infusion, functional MRIs were performed as participants completed two tasks. The first task consisted of watching 20-second segments of sexual content alternating with nonsexual segments of exercising for a total of 12 minutes. The second task consisted of an 8-minute video of a heterosexual couple engaging in sexual activities. The primary outcome was the change in brain activity as determined by MRI blood oxygen level-dependent activity in men receiving kisspeptin compared with placebo. Changes in behavioral measures of sexual desire and arousal, correlation analyses between brain activity and psychometric scores, change in penile tumescence and changes in hormone levels were secondary outcomes.

Kisspeptin enhances sexual brain processing

MRI scans revealed kisspeptin enhanced activation of the left middle frontal gyrus and left anterior cingulate cortex. Deactivation was observed in the bilateral parahippocampus among men receiving kisspeptin. Men with higher self-reported sexual desire distress at baseline had greater kisspeptin-enhanced brain activity in the posterior cingulate cortex while viewing short sexual videos (r = 0.53; P = .002), and the degree of kisspeptin enhancement in the globus pallidus with the short videos was positively correlated with how sexually “naughty” they felt as determined through the Sexual Arousal and Desire Inventory (r = 0.47; P = .007).

Kisspeptin was associated with a greater increase in penile tumescence during the long video task compared with placebo (P = .002). The greatest effect occurred by the end of the task, where kisspeptin augmented penile tumescence by as much as 56% more than placebo. The difference was attributed to kisspeptin increasing activity in the right fusiform gyrus and bilateral visual cortex more than placebo.

“The study participants underwent MRI during this study,” Comninos and Dhillo said. “This is clearly not the most comfortable environment and so we were surprised that kisspeptin administration had such a potent boosting effect on sexual pathways, behavior and the penis in this clinical environment. Hopefully kisspeptin may perform even better in this regard in more comfortable surroundings, such as an individual’s home environment.”

No adverse events reported

Men with a lower baseline overall sex satisfaction had greater kisspeptin-enhanced activity in the putamen (r = –0.61; P < .001). Enhanced activity of the putamen was correlated with increased measures of sexual desire (r = 0.52; P = .002) and sexual arousal (r = 0.5; P = .004). Kisspeptin increased happiness about sex by 0.63 points more and participant-reported flushing by 0.63 points more than placebo according to those subscales of the Sexual Arousal and Desire Inventory.

Kisspeptin was well tolerated with no side effects or adverse events reported. The agent also had no clinical effects on blood pressure or heart rate.

“It is important to stress that this is early work,” Comninos and Dhillo said. “There is much to do. We are looking at performing larger studies, examining the effects in individuals with different identities and sexualities, and administering kisspeptin-based treatments in easier ways.”

For more information:

Alexander Comninos MD, PhD, can be reached at a.comninos@imperial.ac.uk.

Waljit S. Dhillo, MD, PhD, can be reached at w.dhillo@imperial.ac.uk.

Reference:

Kisspeptin hormone injection could treat low sex drive in women and men. https://www.imperial.ac.uk/news/242901/kisspeptin-hormone-injection-could-treat-drive. Posted Feb. 3, 2023. Accessed Feb. 3, 2023.