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a cactus flopping over as a metaphor for low testosterone myasthenia gravis

Myasthenia Gravis Drugs and Low Testosterone

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By Editorial Team

3 min read

Issues with sexual function are common for men with myasthenia gravis (MG). A common problem is low testosterone levels. MG does not directly cause low testosterone or other related problems. But MG drugs and other related factors increase the risk of these issues.1,2

Hormones such as estrogen and testosterone have known effects on the activation of the immune system. Research suggests that low testosterone levels may increase the risk of developing an autoimmune disease, including MG. Talk to your doctor if you notice symptoms of low testosterone. Many men shrug off these symptoms as a natural part of aging. But these symptoms can affect your quality of life. Your doctor can help find the right treatment for you.3,4

How does MG affect sexual health?

Issues with sexual function are common in men with MG. The severity of MG does not affect sexual health. This is because MG does not directly cause sexual impairment. But some MG drugs may cause:1,2,5

  • Low testosterone
  • Low sex drive
  • Failure to get or keep an erection (erectile dysfunction)

Some MG drugs that may cause sexual impairment are:1,2,5

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  • Deltasone® and others (prednisone)
  • Cellcept® (mycophenolate mofetil)
  • Azasan® and Imuran® (azathioprine)
  • Mestinon® (pyridostigmine bromide)
  • Rheumatrex® and Trexall® (methotrexate)

Other factors linked to MG also play a role in sexual health. Men with MG have a higher risk of:1,2

Age, depression, anxiety, diabetes, vascular diseases, and some drugs are big risk factors for sexual impairment.1,2

What is low testosterone?

Low testosterone is also called male hypogonadism. It happens when the testicles do not make enough testosterone. Testosterone is the main male sex hormone. It helps develop male traits and sex organs. It is also needed to produce sperm.3

Low testosterone causes different symptoms at different ages. Common symptoms in adult men include:3

  • Low sex drive
  • Erectile dysfunction (ED)
  • Loss of armpit and pubic hair
  • Shrinking testicles
  • Hot flashes
  • Low or zero sperm count
  • Higher body fat with lower muscle mass
  • Depressed mood
  • Trouble with focus and memory

Common symptoms in boys include:3

  • Slow growth in height
  • Less growth of pubic hair
  • Less deepening of voice
  • Low strength and endurance

Low testosterone can have many causes. Conditions that affect the testicles can lead to low testosterone. Conditions or drugs that affect certain other hormones can also cause low testosterone. For men with MG, drugs are a potential cause.1,3

What is erectile dysfunction?

ED is a failure to get or maintain an erection. ED is very common. It affects more than half of men between the ages of 40 and 70 years. Common symptoms of ED include:6

  • Trouble getting an erection before sex
  • Failure to maintain an erection during sex
  • Complete failure to get an erection
  • Need for a lot of stimulation to keep an erection

ED can be caused by:6

  • Low testosterone
  • Conditions that affect your blood-vessel system or nervous system
  • Certain medications
  • Recreational drugs and substances

How does low testosterone increase the risk of MG?

Research suggests that low testosterone increases the risk of MG. Testosterone naturally suppresses the immune system. Because of this, low testosterone can increase the risk of autoimmune conditions like MG. These are conditions where the body’s immune system attacks the body itself.4,7

Testosterone naturally decreases as men age. This may explain why most men affected by MG are over 50 years old. More research is needed to understand the effects of testosterone on MG.4,7

How do doctors diagnose low testosterone?

Testosterone levels below 300 nanograms per deciliter (ng/dL) are low. If you have symptoms of low testosterone, your doctor will do a physical exam. They will ask about your medical history. They may test your blood for total testosterone levels. Other blood tests may also help determine possible causes.3

How is low testosterone treated?

Doctors treat low testosterone with replacement therapy. This increases your levels of testosterone. Some options for testosterone replacement therapy are:3

  • Skin gels or patches
  • Injections into a muscle
  • Pellets implanted under the skin
  • Tablets applied to the gums
  • Nasal gels
  • Pills taken by mouth

Many of these treatments can cause side effects. Talk to your doctor about the risks and benefits of testosterone replacement therapy.3

Lifestyle habits can also help maintain normal testosterone levels, such as:3

  • Keeping a healthy diet
  • Getting regular exercise
  • Managing your weight
  • Reducing alcohol or drug use

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