Understanding Hypoactive Sexual Desire Disorder in Women

Many couples face issues with mismatched libidos, where one partner has a lower sex drive than the other. For some women, a chronically low interest in sex may be caused by a condition called hypoactive sexual desire disorder (HSDD). HSDD is characterized by an ongoing lack of sexual desire that causes distress. In this article, we’ll explore the causes of HSDD and provide solutions to help improve female sexual desire.

What is Hypoactive Sexual Desire Disorder?

Hypoactive sexual desire disorder (HSDD) is a sexual health disorder characterized by a chronic lack of interest in sexual activity. Women with HSDD do not fantasize about sex or desire it. This persistent low libido causes personal distress and negatively impacts relationships. HSDD is one of the most common female sexual dysfunctions, affecting roughly 10% of adult women in the US. The causes of low sexual desire are complex and varied. HSDD can stem from medical issues, mental health problems, relationship troubles, or a natural decline in sex hormones like estrogen and testosterone. Treatments for HSDD aim to address the underlying cause of diminished libido. Let’s explore some of the key factors behind this disorder.

Medical Causes of Low Female Libido

Many medical conditions can dampen a woman’s sex drive. Getting a full health workup is important to identify and treat any issues that may be contributing to low desire. Here are some of the most common medical causes of HSDD: Diabetes – Poorly controlled blood sugar levels from diabetes can lead to nerve damage and reduced blood flow, which may impair sexual arousal. Depression and anxiety – Mental health issues like depression or anxiety disorders commonly cause loss of libido in women. The stresses and mood changes of these conditions diminish sexual interest. Menopause – Declining estrogen levels during menopause cause physical and emotional changes that can lower libido. Vaginal dryness and discomfort during sex after menopause also discourage desire. Medications – Some prescription drugs like antidepressants, blood pressure medications, and opioids can reduce female sex drive as a side effect. Low testosterone – Testosterone plays a key role in female sexual desire, and low levels after menopause or from other medical issues can contribute to HSDD. Thyroid disorder – Both overactive and underactive thyroid function influence sexual desire and arousal. Getting a full medical checkup can identify problems that may be impacting libido. Treating the underlying condition may help improve sexual desire.

Using Testosterone Therapy to Treat HSDD

For postmenopausal women with low testosterone, hormone replacement therapy with testosterone can be an effective treatment for HSDD. Testosterone treatments help restore testosterone levels back to premenopausal ranges, which alleviates the effects of low testosterone on libido. Some key points about testosterone therapy for women: Testosterone therapy is only FDA-approved for postmenopausal women with HSDD, not premenopausal women. The goal is to increase testosterone levels back to normal premenopause ranges, not supraphysiological levels. Properly dosed testosterone will not cause excess hair growth or masculinization in women. Testosterone is available as pills, topical creams and gels, injections, and pellet implants. Effects may take several weeks or months to fully develop. Potential side effects include acne, hair loss, and increased cholesterol levels. Under proper medical supervision, testosterone therapy can successfully treat HSDD caused by low testosterone after menopause or surgical removal of the ovaries. For premenopausal women, addressing other causes of low desire is recommended over testosterone therapy.

Prescription Medications for Treating HSDD

Along with testosterone, two other medications have been approved by the FDA specifically to treat HSDD: Bremelanotide (Vyleesi): This injectable medication activates receptors in the brain that regulate sexual arousal and desire. It is self-administered about 45 minutes before anticipated sexual activity. Flibanserin (Addyi): This oral pill treats HSDD by regulating neurotransmitters like dopamine and serotonin in the brain to increase sexual desire. While both medications have demonstrated modest improvements in desire and sexual satisfaction, their efficacy and side effect profiles have been controversial. Many experts argue that counseling and lifestyle changes should be explored first before trying these drugs. As with any medication, a woman should thoroughly discuss the pros and cons with her healthcare provider when considering HSDD therapy.

Addressing Relationship and Psychological Issues

For many couples coping with mismatched libidos, psychological and interpersonal factors are major contributors to low female desire that should be explored. Mental health counseling and sex therapy can help uncover and resolve issues like: Stress – Chronic stress depletes feel-good neurotransmitters like dopamine that promote libido. Stress management helps. Poor body image – Negative body image diminishes sexual confidence and desire. Trauma history – Past sexual trauma or abuse can cause many women to avoid sexual intimacy. Relationship problems – Lack of emotional intimacy, anger, or resentment towards a partner destroys sexual desire. Mood issues – Anxiety, depression, and other mood issues affect libido. Lack of arousal – Many women need to feel aroused first before desire emerges. Focusing on enhancement of arousal is important. Working through these psychological barriers to intimacy and desire through counseling and conscious efforts to improve the relationship and sexual dynamics are crucial.

Using the 5 Love Languages to Improve Intimacy and Desire

The book “The 5 Love Languages” provides a useful framework for understanding how to foster intimacy, passion, and sexual desire in a relationship. The key premise is that people give and receive love in 5 primary “languages” or ways: Words of Affirmation – praise, compliments, verbal expressions of love Acts of Service – doing things for your partner Receiving Gifts – thoughtful gifts symbolize love Quality Time – focused attention and togetherness Physical Touch – affectionate touch, hugs, sex, physical intimacy People have innate primary and secondary love languages. Mismatches in how partners communicate love can harm the relationship. Identifying your spouse’s love language and tailoring expressions of love accordingly helps fill their “love tank” and enhances intimacy and emotional connection. This stronger foundation revitalizes sexual desire. Making heartfelt efforts to speak your spouse’s love language helps overcome many of the psychological barriers dampening libido – stress, resentment, loneliness, body image issues, etc. Prioritizing quality time together and affectionate physical intimacy are especially beneficial.

The Takeaway – Reviving Female Sexual Desire Takes Patience and Understanding

In summary, hypoactive sexual desire disorder in women has no single cause or solution. The keys are addressing any medical issues impairing desire, exploring prescriptions options if appropriate, and consciously working to enhance intimacy and romance in the relationship. Patience, empathy, and communication are vital. With time and effort, the woman struggling with low libido can regain her sexual desire, passion, and satisfaction.