Sexual desire is a normal part of human sexuality, but is it essential?
There are two types of sexual desire: spontaneous and responsive. What we see acted out in movies is spontaneous desire - that internal arousal or desire to connect with a partner. Responsive desire is occurs in response to starting sexual stimulation or sexual activity.
For most in a long term relationship responsive desire is more common. We often think something is wrong with us if we don't have that spontaneous deisre we once felt at the beginning of a relationship. Nothing has gone wrong - this is normal.
Even so, for some women, a lack of desire can be a source of distress and frustration. Decreased sexual desire, also known as hypoactive sexual desire disorder (HSDD), is a common concern among women. 57% of women believe they are having too little sex. Women with HSDD are 8 to 10 times more likely to report feeling unhappy, disappointed, frustrated, ashamed or bitter.
When you see a provider about this concern, they will be looking at all these aspects. We know the impact of HSDD can be significant, affecting self-esteem, relationships, and overall quality of life. The first step is to work with your provider to understand what is causing low desire - and advocate for yourself!
Relationship issues, poor body-image, and history of trauma can all cause decreased desire and merit an inter-disciplinary approach going beyond the OBGYN's office.
There are a treatment options for increasing sexual desire. Addyi (fibanserin), Vyleesi (Bremelanotide), and testosterone are a few great options.
Addyi (flibanserin) is an FDA- approved medication that works by altering the levels of certain neurotransmitters in the brain. This has been shown to increase the frequency of satisfying sexual events and decrease the distress associated with HSDD.
Vyleesi is a self-administered injectable medication that increases sexual desire by increasing levels of melanocortin, a hormone involved in sexual response.
Testosterone therapy is also a potential option for women with HSDD, particularly those who have gone through menopause and are experiencing a decrease in testosterone levels. Testosterone therapy can help increase sexual desire and improve overall sexual function.
It's important for women to talk to their healthcare provider about their sexual concerns and seek treatment if necessary. HSDD is a treatable condition, and the International Society for the Study of Women's Sexual Health (ISSWSH) encourages women to take an active role in their sexual health. With the right approach and the right treatments, women can regain their sexual desire and experience a more fulfilling sex life.