Sex
the sexpert
Is There A Pill for Low Libido in Women?
When it comes to sexual desire, it's complicated. Dr. Trina Read explains why drug companies may be educating the public on a problem that can't be cured with a pill.

Low libido one of the most common problems presented in sex therapy. It is estimated that approximately 20 percent of men and 33 percent of women are affected by low or absent sexual desire, and now drug companies are working to create a "pink Viagra" to boost women's libido. But are drug companies working to sell a product women don’t need? And is there anything inherently wrong with drug companies wanting to help women with a low libido?

Not wrong… sketchy. The race by drug companies to get a female libido enhancing "pink Viagra" to market could, of course, mean billions of dollars in shareholder profit. In the long line of attempts over the years, pills to correct low libido is back in the news.

Several years ago a drug called Flibanserin was developed; however, the drug company dropped efforts in 2010 after being declined by the FDA who requested more research. A smaller company took the work over in 2011. They resubmitted an application recently and were once again declined by the FDA.

In the meantime, I noticed this past year many credible news releases talking about a condition called: hypoactive sexual desire disorder or HSDD. Although this is purely speculation, it seems some companies are doing the necessary behind-the-scenes PR before unveiling a new drug. Let me explain my skepticism:

Why do you say HSDD is no longer a "real condition?"
In the The Diagnostic and Statistical Manual of Mental Disorders or DSM 5, released in May 2013, changed the diagnosis of low libido. It replaced HSDD with sexual interest/arousal disorder. A big reason why it was replaced is the condition of HSDD had too broad a definition, "An absence of sexual fantasies and desire for sexual activity." This is in part because HSDD model was derived from studies on predominantly male subjects.

How is it the terminology has changed but the thinking around HSDD is still the same?
HSDD was based on a linear male model, stating desire precedes arousal in the form of fantasizing, yearning, and looking forward to the experience—a.k.a. "spontaneous" desire. The problem is this framework is infrequent in many functional and satisfied women, especially those in established relationships.

For many women arousal is responsive, occurring at some point after she has chosen to engage in the experience. Moreover, studies confirm women mostly accept or initiate for reasons other than desire—such as to increase emotional bonding, or a response to romantic setting.

Which calls into question: is the estimated number of women with a desire disorder really accurate because we still expect women to have spontaneous desire rather than responsive desire.

Have the pharmaceutical companies over diagnosed low libido by relying too heavily on the condition of HSDD?
That’s exactly it. In 1998 when Viagra came on the scene, it was a credible product because it helped male sexual dysfunction. Drug companies knew they needed a female sexual dysfunction condition to credibly sell her a product. Which is why they ran with the HSDD model.

Let’s be real, there are many desperate women who would love after an endless day of work, taking the kids to soccer, making supper and cleaning up, to simply take a pill and be in the mood for sex. Currently non-FDA approved libido enhancing drugs are a major dollar industry.

In trying to seize this opportunity what we see from drug companies are a well orchestrated marketing blitz, which has little to do with science. Even though data hasn't been released and no breakthroughs have been discovered, what the public hears through news releases is: women with a lack of desire suffer from emotional distress and it is a common crisis within their relationship.

What we need to ask is: why are drug companies investing heavily in research, surveys and patient registries to indicate there is a disorder, while at the same time creating medication to treat this condition.

But a lack of desire is a big, contentious issue for couples.
You’re right. Sexual desire is elusive and a difficult thing to define—if we had a thousand people in a room, each would present a different sexual desire. Lack of libido is not a simple checklist of things, and if you check all the boxes you can be prescribed medication.

Many women and men do report dissatisfaction with sex, but that does not mean they are dysfunctional. More likely it is due to a variety of interrelated factors—physical, psychological and social.

Men and women do experience sexual problems causing them distress, discomfort and dissatisfaction. Although they need attention it is neither a clinical condition nor dysfunction, and it is wrong for drug companies to manufacture a precondition.

What are some every day things that can affect a women’s libido?
Because there is so little factual sex education in our society, we are instead bombarded with Cosmo-type titillating articles about how to improve your sex life and it leaves the majority feeling that if you have low libido you are abnormal. When in truth, there are so many obstacles getting in the way to feel spontaneous or even responsive desire.

Something as simple as: if you’ve had a fight in the morning, chances are no nookie will happen that night. Other things that heavily contribute are: do you have good communication with your partner? Do you have a healthy sexual self esteem? What were the messages in your upbringing?

There are also external things like: birth control pills, antidepressants, allergy mediations, alcohol, high cholesterol, and thyroid problems. Also, chronic sleep deprivation messes with your hormones and hits your libido like a torpedo.

What is your bottom line on libido and libido enhancing drugs?
I’m sorry to say the chances are slim that one day women can take a pill which will overcome the complex myriad of things that make up her will, want and desire to have sex.

Instead couples need to roll up their sleeves and talk about the plethora of different solutions/ options available. Also, be aware by accepting a band-aid solution like a pill or a patch and thereby medicalizing sexual libido, it will only serve to restrict sexual desire in the long term.

Dr. Trina Read is the founder of VivaXO.com; a leading relationship and sexual health expert and educator; and is a best selling author, media expert, syndicated blogger, international speaker, magazine columnist, and spokeswoman. Trina has just launched Sensual Tastes Events, an interactive workshop blending the pleasures of food and sex education. Follow her on Twitter and Facebook.


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