Sexual Empowerment

Thanks Dr. Krychman for helping pave the way for a pharmacologic treatment for HSDD.

By Michael Krychman, MD 

 

As a sexual medicine physician and sex counselor, I’ve noticed a societal shift towards greater acceptance and awareness of   female sexual empowerment and expression.  More and more women are owning their sexuality and speaking out about it -- sometimes in a way that is considered risqué --  but, at least they are talking. 

 

Do not get me wrong, many women I see in my practice would rather keep their sex lives behind closed doors for a variety of reasons. And some women do not have much in the way of sexual interest based on religious or cultural beliefs, or, in some cases, due to psychological issues or problems in their relationship. But what about those women who feel left out of sexual empowerment not because of their own set of personal beliefs or treatable psychological issues, but rather a biologically driven lack of sexual desire that is out of their control? 

 

According to a recent article   published in the journal Menopause, the rate of low sexual desire is high, reaching 43 percent, while an estimated 10 percent of women experience low sexual desire with the hallmark characteristic of distress, a condition called hypoactive sexual desire disorder, or HSDD.

 

Hypoactive sexual desire disorder is defined in medical literature as a “persistent or recurrent deficiency or absence of sexual fantasies and desire for sexual activity that causes marked distress or interpersonal difficulty, and which is not better accounted for by a medical, substance-related, psychiatric or other sexual condition.” Research has shown that women with HSDD are more likely than women who have “normal” desire to experience feelings of frustration, hopelessness, anger, loss of femininity and decreased self-esteem. And they feel there is nothing they can do about it. Even with the new classification system and lumping HSDD and arousal disorder together, the tenets of HSDD remain true and real.  Yes, Virginia, there is such a condition called lowered sexual interest. 

 

Hypoactive sexual desire disorder was first characterized as a medical condition in the Diagnostic and Statistical Manual of Mental Disorders in 1987. There are no FDA-approved pharmacological treatments available for women. Erectile dysfunction was first characterized in 1992. There are 26 FDA-approved treatments for either erectile dysfunction or low testosterone. 

 

While the etiology of erectile dysfunction and HSDD certainly differ, their regulatory pathways seem to have more distinction than would be expected – especially in a time when much emphasis is placed on women’s rights to an active and healthy lifestyle. 

 

As research into female sexuality has advanced, the element of desire has come into focus. We now know that desire is a complex interplay of social, psychological and biological components. If neither social nor psychological components are causing low sexual desire and biology is at play, science now understands that there can be an imbalance of key neurotransmitters, or chemicals, in the brain that affect sexual drive. With this direct correlation between chemical imbalance and desire, there is no reason why, in 2015, a treatment option for women should not be available. 

 

While the science has finally caught up, there remains a disparity in available options to treat sexual dysfunction between genders. The need to equalize this disparity and make a solution available for the millions of women who suffer from HSDD is clear. Men have had proven, FDA-approved treatment options available to them to treat their sexual issues for decades. It is time we have the same for women. 

 

As a medical physician, sex therapist and counselor it is fascinating to me that there still is much hostility between the   camps of sexual medicine and sexual psychology.  We do share one commonality- the concern for the patient and her distress and suffering.  Certainly we meet in the middle ground and embrace science, clinical research and most importantly listen to the patients’ voice.    Both medical sexual pharmacology and counseling will endure as importance facets for the treatment of sexual problems. A true collaborative approach between sexual medicine and sexual psychology, with mutual respect for science, data and facts,  will not only help women regain a lost and vital aspect of their sexuality but will offer an opportunity for solidifying and advancing the field of human sexuality through a team of professionals.  

 

Be Strong. Be Healthy. Be in Charge!

-Michael Krychman MD