Low Sexual Desire / Low Arousal
Hypoactive sexual desire disorder (HSDD) is the medical term for decreased libido. It is one of the most common forms of sexual dysfunction in women. It is defined as the deficiency or absence of sexual fantasies and desire for sexual activity which leads to distress, frustration or inter-relationship difficulties. Many factors play into adult female sexual desire including relationship status, self-esteem, stress, menstrual cycles, hormonal contraceptives, other medications, hysterectomy, perimenopause and menopausal states. The diagnosis of HSDD is made by answering a questionnaire called the Decreased Sexual Desire Screener. HSDD can negatively impact a woman’s quality of life, but treatment is available.
Optimal treatment of HSDD in women includes both a psychological and a physiological approach. Your hormone levels should be tested and some women find that using supplemental compounded testosterone in gel or subcutaneous pellets can be very effective. Low dose vaginal estrogen is also helpful for those menopausal women with vaginal dryness. There are also two FDA approved medications that can be used. The first is Addyi (filbanserin), which is a daily pill.
Addyi works by modulating neurotransmitters in the brain which can increase libido. The other medication is Vyleesi (Bremalanotid) which is a self-administered injection. Vyleesi also works on neurotransmitters to increased desire.
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