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Hypoactive sexual desire disorder (HSDD)
Loss of sex drive, a condition known as hypoactive sexual desire
disorder (HSDD), in women is a persistent lack of desire or absence of
sexual fantasies.
Causes
- Psychological causes such as communication problems, marital
problems, power struggles
- Lifestyle factors also influence the desire for sex. A single
working mom who is overwhelmed by family needs may feel too
exhausted to relax, kick back and fantasize about sex—let alone
engage in it.
- Physical problems such as heart disease, or any other disabling
disease.
- Some medications may also lead to low sex drive:
antihypertensives, antidepressants and birth control pills,
interfere with sex drive, arousal and orgasm by affecting the
balance of sexual hormones and the transmission of chemical
messengers.
- Menopause: Reduced estrogen to postmenopausal levels can lead to
dryness of the vagina making sex painful which reduces motivation.
The gradual decline of the hormones estrogen, progesterone and
testosterone together serve to decrease drive.
- Another cause may be reduced testosterone levels. It has been
argued that increasing testosterone levels even in those without low
levels may also serve to increase sex drive.
- Another hormone currently under study is MSH (melanocyte
stimulating hormone). It has been proposed to be a cause for the
increased sex drive experienced in women at the time of ovulation. A
recent study on female rats has just been published and shows
favorable results. However, the drug is still in the preclincal
testing phase and it will be a long time before we see it on the
market (if it ever makes it).
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Therapeutic options
If the cause is suspected to be psychological then counseling and
therapy for both partners is probably your No. 1 treatment option to
overcome HSDD. Lifestyle factors should be identified and treated.
Medical conditions should be treated optimally.
The antidepressants Prozac, Zoloft and Paxil, of which women are
major consumers, cause loss of libido in as many as 60 percent of
patients. These should be switched to one that has less of a sexual
side effect, like Celexa, Wellbutrin, BuSpar, Serzone or Effexor.
Testosterone level evaluated and if it is below 20 nanograms per
deciliter, consider starting testosterone therapy. Testosterone
therapy is one of the most important stimulants for sex drive
available.
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