The OxyPLEASURE Study - Effects of intranasal Oxytocin on Sexual Well-Being in Patients with Arginine Vasopressin Deficiency (central Diabetes insipidus) and Healthy Controls - a double-blind randomized placebo-controlled crossover trial

Disruption of the hypothalamic-pituitary axis, whether due to inflammation, tumours, or head trauma, can lead to AVP deficiency (AVP-D) – formerly known as central diabetes insipidus (cDI) – characterized by polyuria and polydipsia. Desmopressin, an AVP receptor analogue, is the established treatment for AVP deficiency. 

Despite treatment, patients frequently report residual psychological symptoms, including reduced empathy, heightened anxiety, social interaction difficulties, and decreased sexual desire, substantially affecting their quality of life. Given the anatomical proximity, local disruptions of the AVP system could also disturb the oxytocin (OXT) system, resulting in an additional OXT deficiency. Our recent study utilized a novel stimulation test with MDMA, and revealed for the first time an additional OXT deficiency in patients with AVP-D. These findings may potentially explain the observed psychopathology in these patients. Although psychological changes in patients with anterior pituitary dysfunction are well-recognized and managed with respective hormonal replacement therapy, few efforts have been made to assess psychological comorbidities in patients with isolated AVP deficiency. Research on this condition is generally limited due to its rarity (currently affecting approximately 15,000 patients in Europe), especially on sexual desire and related outcomes.