Hypoactive Sexual Desire Disorder

The Hormone Gal: Jari Becker, RPh

Director of Women’s Health and pharmacist Jari Becker, RPh gives her take on women’s health, offers her expertise, and invites you to join upcoming women’s events. She has connected women with answers about hormone imbalances, and guides prescribers through the untapped potential of bioidentical hormone replacement therapy (BHRT).

Sexual dysfunction is often thought of as a men's health issue, and that assumption shows up in the numbers: nearly two dozen FDA-approved medications exist to support men's sexual health, compared to only a small handful approved for women. That gap does not mean women's symptoms are less common or less deserving of attention. It means the options have lagged behind. More women are speaking up about these symptoms with their physicians, and more pharmacists are working alongside prescribers to develop patient-specific therapy.

What Is Hypoactive Sexual Desire Disorder

Hypoactive Sexual Desire Disorder describes persistent or recurring problems with sexual response, desire, orgasm, or pain that cause distress or strain a relationship. It can occur at any stage of life, in certain situations or across all sexual activity, and it may appear and resolve at different points across a woman’s life.

Sexual response is not just about attraction or connection. It involves physiology, hormones, emotional wellbeing, life experience, and relationship dynamics working together. When any one of these pieces is disrupted, desire, arousal, or satisfaction can be affected.

Common Types of Hypoactive Sexual Desire Disorder

Low sexual desire: reduced or absent interest in sexual activity, or fewer sexual thoughts and fantasies than before.

Arousal difficulty: desire may be present, but the body has trouble becoming or staying aroused during sexual activity.

Orgasmic difficulty: a marked delay, reduced intensity, or persistent absence of orgasm.

Sexual pain: pain or pelvic tightening associated with vaginal penetration, or fear and anxiety about that pain.

Signs Women Can Discuss With Their Prescriber

Women who identify with three or more of the following may want to raise the topic of Sexual Interest / Arousal / Orgasmic disorder at their next appointment:

Reduced interest: little or no interest in sexual activity or erotic thoughts.
Reduced initiation: has stopped initiating sexual activity and is often unreceptive to a partner’s attempts to initiate.
Reduced pleasure or sensation: little or no excitement, pleasure, or genital and nongenital sensation during almost all sexual encounters.
Reduced response to cues: little or no arousal in response to erotic cues, whether written, verbal, or visual.
Orgasm changes: marked delay, infrequency, absence, or reduced intensity of orgasm.
Pain or tensing: pain, pelvic pain, fear of pain, or marked tensing of the pelvic floor muscles during attempted vaginal penetration.

Hormonal Changes and Other Contributing Factors

Menopause is a common contributor, and early onset of menopause can also result from chemotherapy or radiation. Hypoactive Sexual Desire Disorder is not limited to hormonal changes or to women in midlife, however; younger women without hormonal changes can experience it as well. Women are increasingly comfortable discussing intimate concerns with their prescribers, and vaginal dryness, low sex drive, and difficulty reaching orgasm are among the most common concerns they raise.

Research reflects how widespread this issue is. A systematic review and meta-analysis by McCool et al. found that female sexual dysfunction affects a substantial share of premenopausal women worldwide, and the authors called for more research and better standardization in the field.

Testosterone Therapy for Women

Testosterone is often thought of as a male hormone, but testosterone therapy for women plays an important, if often overlooked, role in restoring hormonal balance. When levels decline, whether from age, menopause, surgical or medical oophorectomy, or adrenal changes, women can experience a cluster of complaints that are frequently overlooked or attributed to other causes.

Read the blog: Testosterone Therapy for Women: Why Dosing and Delivery Matter →