Hey guys, my name is Dr. Sam
and lately some of you have asked me to make a
video on low libido in women.
And asked me to explain, in English, what is
Hypoactive Sexual Desire Disorder or HSDD?
If you keep watching, I'll walk you
through the common, symptoms, causes
and treatments for low libido in women.
So let's go!
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So Hypoactive Sexual Desire Disorder
HSDD is a very fancy term for loss of
sexual desire or loss of libido.
This can happen to both men and women but today
I'll focus on how it affects ladies.
It is extremely common and even more so
with age.
It affects between 26 to 43 percent
of women and in some studies
over half of women, post menopause,
complain of decreased libido.
"Leslie, I typed your symptoms into the thing up
here and it says you could have network
connectivity problems.
What are the symptoms of HSDD in women?
A lack of interest in sexual fantasies and a
lack of desire for sex.
It's considered a disorder if it causes
distress for women or the woman's relationship
and is present for a period of time.
What causes low libido in women?
I understand if you're wanting to skip
ahead to the treatments but I'm telling
you that the answer to low libido is in
treating the cause.
There are many causes of low libido in women,
which I'll just list in the description below.
But roughly they can be broken down into
four main categories:
Mind, body, medications and relationships.
Mind causes are any form of mental illness
especially depression, which is a very
common cause.
Also overwork, chronic tiredness
or a change in self-image from weight gain,
anxiety - all reduce sex drive.
Body. It makes sense that any medical illness can
reduce libido so it's very common in
women undergoing cancer treatments.
Also changing hormone levels around menopause
and after having a baby are a big culprit.
Anything that causes pain during sex
like vaginal dryness or if a woman is
susceptible to lots of bladder infections,
that can cause low libido.
Medications. Unfortunately, lots of
prescription medicines cause low libido too.
Particularly, blood pressure drugs, contraceptive pills,
mental health medications.
Also women who drink heavy amounts of alcohol will
have reduced sex drive.
Relationships. A big elephant in the room
but relationship problems can
drastically affect libido.
Not surprisingly. If one partner is less
attracted to the other, if someone is
having an affair, or a couple is
constantly arguing, their libido will drop.
You know nothing Jon Snow.
Should you have tests done for low libido?
If you haven't already seen your doctor it may
be worthwhile getting some basic blood tests done,
which can rule out other causes like
low iron or an underactive thyroid.
But if everything has already been tested,
it's time to move on to treatments.
What are the treatments for low libido?
Like I said before, the key is in treating the cause.
In my experience most people don't just
have one cause but usually have several
that are all interlinked.
Addressing the mind, body, medications
and relationships causes are fundamental .
And I'll link more about this in the description below.
If you have already addressed those
four categories and low libido is still
present, then there are three treatment pathways
that can be considered.
Of course, I'd recommend talking with your doctor
about these yourself,
but I'll try to give you a quick summary.
There is a controversial medication that is FDA
approved for HSDD called
Flibanserin, trade name Addyi.
This changes hormone levels in the brain
that affect sexual desire and studies have shown
that one hundred milligrams of flibanserin
at bedtime significantly improves sexual
desire compared to placebo.
However, the main problem is the side effects.
It's very common to get dizziness, drowsiness,
nausea and dry mouth.
You should not drive or engage in any other activities
requiring your full attention,
until at least six hours after taking Flibanserin.
It's also important not to take alcohol with this
medication as it causes fainting.
Next up, there is an injection that can
be used for pre-menopausal women.
That is women who haven't had menopause yet,
which is called Vyleesi.
It isn't understood exactly how it works,
but it is injected 45 minutes before sex,
under the skin.
In studies, about a quarter of patients
had improved sexual desire compared to placebo.
It does not enhance sexual performance.
Unfortunately, the side effects are a bit rough
with nausea, vomiting, flushing,
injection site reactions and headache.
People who have high blood pressure or
heart disease can't use Vyleesi.
"Blanche, what are you doing lining shelves
on a Friday night ?
I'm working off all my excess sexual energy."
Finally, in postmenopausal woman there is another
medicine to consider.
A systematic review of transdermal testosterone,
which has a trade name called "Intrinsa".
Which had more than 3000 patients with HSDD
showed significant increases in sexual
desire, sexual activity and
reduced personal distress compared with women
in the placebo group.
Testosterone is a very important hormone involved in
sexual desire and unfortunately it isn't
approved by the FDA as there are no
long-term studies confirming its safety
in women.
So women can only use off-label products.
Hopefully, with time there will be more research
around this.
I hope you've found this information
useful. Thanks so much for watching and
I'll see you in the next video!