Summary: Toviaz® is a muscarinic blocker used to treat overactive bladder. It’s well known that muscarinic blockers can lead to a decreased sex drive. There is no direct evidence it lowers orgasm intensity.
Dear Curtis: I’m a female and am taking Toviaz for my bladder. It seems to be helping. However, my orgasms are less intense than before. Is it in my mind or could it be the drug?
Don’t worry – you’re not going crazy. While there is no evidence that Toviaz is directly involved in decreasing the intensity of orgasms. It may be indirectly involved.
Only one problem: in Toviaz package insert, where the company must list the most common side effects and even the not-so-common side effects, there is no mention of study participants experience either a delayed orgasm, decreased orgasm sensation or ability to achieve an orgasm.
However, that does not mean that Toviaz can’t be contributing.
Here’s What I Mean
As you mentioned, your prescribed Toviaz for you for an overactive bladder. For a person’s bladder to be activated in the first place requires certain receptors – called muscarinic receptors. Toviaz is in a class of drugs that act by blocking those muscarinic receptors. The overall effect is that Toviaz lowers the amount of smooth muscle contractions that our bladder has because the muscarinic receptors aren’t receiving the signal to contract.
So far so good.
The problem arises because muscarinic receptors aren’t just in your bladder. They are all over your body. For example, muscarinic receptors are responsible for telling your mouth to secrete saliva. This is one of the reasons why people experience dry mouth with Toviaz. The same with your gastrointestinal tract (again, think smooth muscle contraction there). So, you may also experience constipation.
Effect on Sex Drive
One thing you didn’t mention, but would be helpful to know, is what is your sex drive like?
Here’s why I ask: it’s well known that muscarinic blockers, like Toviaz, interfere with libido, or sex drive. Additionally, the orgasm, while simple from a 35,000 foot view, get’s pretty complicated when you start looking at each individual step.
But, here is a good way to think about it. Your Parasympathetic Nervous System (PNS) is activated and leads to arousal. Then, your Sympathetic Nervous System (SNS) is activated during orgasm. Followed by a rebound in your PNS after orgasm.
Muscarinic activity, which Toviaz blocks, is involved in the initial PNS surge. So, you may likely find that your sex drive has decreased. This leads to the chicken or the egg question. Is your decreased ability to achieve initial arousal affecting the quality and intensity of your orgasms?
In short, there is no evidence that Toviaz directly effects orgasm – that is more of an SNS activity. However, it’s clear that Toviaz can effect your sex drive. In doing so it may effect the overall quality of your orgasm.
While some may suggest that you try a different drug to treat the overactive bladder every drug that I have seen successfully used works in the same way. They are all anticholinergics and can lower sex drive.