Welcome back to my channel.
Today we are doing part two of low libido.
We are talking about treatments that can help women with low libido.
If you're new here I'm Dr. Rena Malik, urologist and pelvic surgeon.
We talk about urologic conditions bladder health, sexual health, and much, much more.
So if you like what you see, make sure you subscribe and share this channel with your
friends.
Just to recap from our last video, low libido is very, very common, it affects about 40%
of women, but only 12% of women are really bothered by it.
So I talked about all the risk factors for low libido in my last video, and if there
are medical conditions that I listed there, or medications that you're on, certainly you
want to tackle those issues first, because fixing those can potentially fix the issues
of libido.
So let's start with easy things.
What are some lifestyle changes that can maybe increase libido.
So it sounds pretty straightforward.
But things like fatigue and stress are big contributors to low libido.
So working on improving those things can be really helpful.
And like how do you really do that, while trying to prioritize your sleep or if you're
worried that you might have a sleep disorder, make sure you go talk to your primary care
doctor about that.
See if you can get help with children, if you have small children at home, trying to
get someone to help with them.
So you not so tired all the time, which is easier said than done.
I know for some people, that's not an option.
And that's not affordable.
But certainly even asking a neighbor or friend for help some time can be helpful.
Also trying to incorporate exercise, yoga, mindfulness, other sorts of meditation things
that that that can reduce stress may be helpful for you.
And also, if you are able to get that friend to help or hire a babysitter or have you know,
grandma, watch the grandkids, having a date night with your spouse, even once a month
can be really important in trying to rebuild good relationship with your partner so that
you can kind of rebuild that intimacy.
Certainly, as I mentioned in my last video, there can be a lot of relationship issues
that can contribute to low libido and communication with your spouse is key.
And so in those cases, a lot of times going to a sex therapist or going to couples therapy
can be extremely helpful.
But what can you really expect during couples therapy?
Well, it depends.
If you go to a sex therapist, from my understanding, most people will generally work on first educating
the couple on what the normal sexual response cycle is address any specific maybe religious
or cultural concerns that you may have about having sex, what is a normal expected frequency
for you as a couples to have intercourse and maybe even including some specific exercises
and offering resources like books, visual aids devices like vaginal dilators, and specifically
focusing on mutual sexual pleasure which if you miss my video with Lisa Mangaldas, we
talk about that a lot in the sense that a lot of times women don't even really focus
on their pleasure when they're so focused on their partner's pleasure and that at least
85% of women do need clitoral stimulation to achieve orgasm.
And so making sure that your partner is aware of that and incorporates your pleasure into
the relationship and into intimacy time can be very, very valuable for low libido.
So another type of therapy that's offered is called sensate therapy.
And this is essentially a therapy that's focused on touching and it starts with touching non
genital areas, and you slowly kind of advanced to touching in more erogenous areas.
But essentially, it's meant to reduce anxiety and reduce the avoidance of sexual intimacy
and also improve intimacy.
And particularly for women who have concerns about pain with penetration, this can be really
helpful.
Also, you can engage in cognitive behavioral therapy, which really focused on the thoughts
and behaviors that kind of come in the way when you're about to have intimacy or sexual
relationships with your partner to really focus on what if those thoughts and behaviors
are kind of automatic or maybe getting in the way of proceeding with sexual intimacy.
But if you've tried all these things, and your relationships great, and you're super
healthy, and there's nothing else going on that might be causing this low libido, there
are two FDA approved medications for low libido in women.
The first one is called Phil Bansuri.
In or brand name is Addie.
It's a medication that's taken once a day at bedtime.
And what it does is it works on serotonin receptors to essentially increase the brain
dopamine.
So like I talked about in my last video, dopamine is a key neurotransmitter or chemical messenger
that causes sexual excitation.
And so it's taken once a day at nighttime because it does cause some drowsiness it's
specifically only approved for women who are pre menopausal, meaning they have not yet
gone through menopause.
You do need to give it a good eight week trial to see if it works.
And there are some side effects to be aware of specifically being very sleepy that's why
you take it at night and there are low risks of getting low blood pressure dizziness, fatigue
or not
As the hours are commonly seen in the studies, however, in the studies, only 13% of people
actually stopped the medication due to side effects.
You do need to be careful taking this with alcohol because both of those together can
make the drowsiness much more significant.
And so it's not recommended to take it with alcohol at the same time.
Certainly you need to delay for a certain amount of amount of time after having one
or two drinks.
Or if you have three or more you shouldn't take your dose that night.
In this study, they found that libido increased about 54 to 58% for all women who were on
this medication, so certainly not a homerun but certainly can have many, many women who
are suffering from low libido specifically if you're pre menopausal.
Another medication that's available for those who are pre menopausal is called free Melano.
Tide free Malana tide is an injection that you give yourself before you want to have
intercourse, you need to give it to yourself about 45 minutes before you want to have intercourse
or engage in sexual activity of some kind.
And in the studies that actually showed improvement in sexual satisfaction and desire in about
51 to 57% of participants.
It shouldn't be used if you have uncontrolled high blood pressure or if you have cardiovascular
disease.
And the most common side effect is nausea with the injection, but the nice part about
it is you just take it before you want to use it.
You also do need to be on some sort of contraceptive or using some sort of protection if you're
using this medication because it can cause unwanted side effects or harm to a developing
fetus.
So there are also some off label treatment options which I'm going to touch on briefly
and if you want to learn more about them, please comment below one is using topical
testosterone for women who are postmenopausal.
So like the other two medications were for pre menopausal women.
This is for postmenopausal women.
Well another couple of medications that have been shown off label to help are Bupropion,
which is an antidepressant and buspirone and anti anxiety medication and so those are all
used off label for the use of low libido in women if you have tried other things have
a normal healthy relationship and no other issues that need to be addressed.
I hope this is helpful to you please comment below let me know if you liked it and what
more you want to learn about as always remember to take care of yourself because you're worth
it.