Low sexual desire in women: symptoms, diagnosis and treatment

Hypoactive sexual desire disorder (HSDD), now known as female sexual interest/arousal disorder, is a sexual dysfunction that causes decreased sexual desire in women.

Many women may mistake HSDD symptoms for the inevitable effects of aging or body changes. If your sex drive is affecting your quality of life, maybe it's time to talk to your doctor.

What are the symptoms of HSDD?

While it's healthy for sex drive to fluctuate, a woman with HSDD often experiences a lack of sex drive for six months or longer. If changes in sex drive are so extreme that they affect your relationships or self-esteem, it could be HSDD. Symptoms associated with HSDD include:

• little or no interest in sexual activity
• few or no sexual thoughts or fantasies
• disinterest in initiating sex
• difficulty getting pleasure from sex
• lack of pleasurable sensations when the genitals are stimulated

How do doctors diagnose HSDD?

Unlike other medical conditions, there is no specific test to diagnose HSDD. However, there are some methods used by doctors to diagnose the condition. Start by telling your doctor about your symptoms. Your doctor may ask you questions about how your low sex drive is affecting your well-being. Your doctor will try to identify an underlying cause for the condition. These causes can be physical, emotional or a combination.

Physical causes of HSDD can include: arthritis, coronary artery disease, diabetes, low levels of estrogen or testosterone, hormonal changes during or after pregnancy, fatigue or exhaustion from a stressful work, family or school schedule, and/or taking certain medications that affect sexual desire. Emotional causes of HSDD include: a history of anxiety, depression or low self-esteem, sexual abuse, trust issues with a sexual partner.

Your doctor may also perform a pelvic exam to identify any changes that may have affected your sex drive. A blood test to check the affected hormone levels may also be performed. However, sometimes there is no specific underlying cause for HSDD. This does not mean that HSDD cannot be treated.

How do doctors treat HSDD?

There are several methods used to treat HSDD. To find the right treatment, it's critical to understand the underlying cause of your symptoms. Your doctor may ask if you are taking any medications. Certain medications can negatively affect sexual desire.

For example, some antidepressants can cause a decrease in sex drive. In these cases, the doctor may suggest a medication with fewer side effects. Do not stop taking antidepressants without a doctor's approval.

If it seems that emotional issues are at the root of your symptoms, your doctor may be able to suggest counseling. An expert can not only teach you how to communicate better with your partner, but can also help you identify sexual techniques for a more pleasurable experience.

It is common for premenopausal and postmenopausal women to experience changes in estrogen levels. This is due to reduced blood flow to the vagina. If reduced estrogen levels are causing your HSDD symptoms, estrogen therapy may be suggested. Your doctor will recommend applying a cream, suppository or ring that releases estrogen into the vagina. This can increase blood flow without the unwanted side effects that come with taking an estrogen pill.

Another treatment option is the flibanserin pill (Addyi). This medication has been shown to increase sexual desire in premenopausal women with low sexual desire. However, the drug is not for everyone. Possible side effects include hypotension (low blood pressure), fainting and dizziness.

The injectable drug bremelanotide (Vyleesi) has also been approved to treat low sex drive in premenopausal women. Possible side effects include severe nausea, injection site reactions, and headache.

Lifestyle changes can also relieve stress and help improve a woman's libido. These include:

• regular exercise,
• make time for intimacy,
• sexual experimentation (such as different positions, role play, or sex toys),
• avoid substances that affect sexual desire, such as tobacco and alcohol,
• practice stress relief techniques such as mindfulness-based interventions.

Kegel exercises or pompomism are highly recommended in these situations. Read more about it.

Don't underestimate the effect that a decrease in sexual desire can have on your well-being. If you feel that your HSDD symptoms have affected your quality of life, talk to your doctor.

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