Introduction

Hypoactive Sexual Desire Disorder (HSDD) or low libido are complex and often misunderstood sexual health conditions that affects 36-39% of women. It is characterized by a persistent and distressing lack of interest or desire for sexual activity. While occasional fluctuations in sexual desire are normal, HSDD is a chronic condition that can have a profound impact on an individual’s quality of life and relationships. In this blog, we will explore the causes, symptoms, and available treatment options for HSDD, shedding light on a topic that is often shrouded in silence and stigma.

Understanding HSDD

HSDD is more than just a temporary decrease in sexual desire. It is a medical condition that requires attention and care. To be diagnosed with HSDD, an individual must experience a persistent and distressing lack of sexual desire for at least six months. It is important to note that HSDD is not solely related to relationship issues, stress, or other life circumstances; rather, it is a multifaceted condition with both psychological and physiological components.

Causes of HSDD and Low Libido

HSDD can be caused by a variety of factors, and its root causes can differ from person to person. Some common factors that may contribute to HSDD include:

1. Hormonal Changes: Fluctuations in hormone levels, such as those that occur during menopause, can lead to a decrease in sexual desire.
2. Psychological Factors: Stress, anxiety, depression, and past trauma can negatively impact sexual desire and lead to HSDD.
3. Relationship Issues: Problems within a relationship, such as communication difficulties or unresolved conflicts, can contribute to HSDD.
4. Medical Conditions: Certain medical conditions, such as diabetes, thyroid disorders, or chronic pain, can affect sexual desire.
5. Medications: Some medications, including certain antidepressants and antipsychotics, may have a side effect of reduced sexual desire.
6. Lifestyle Factors: Poor sleep, excessive alcohol consumption, and lack of physical activity can all play a role in the development of HSDD.

Symptoms of HSDD and Low Libido

The primary symptom of HSDD is a persistent and distressing lack of interest in sexual activity. However, individuals with HSDD may also experience other symptoms, including:

1. Avoidance of sexual encounters or discussions about sex.
2. Feelings of frustration, guilt, or shame related to their lack of desire.
3. Difficulty in maintaining intimate relationships.
4. Reduced self-esteem and self-confidence.

It’s essential to remember that the severity and manifestation of symptoms can vary widely from person to person.

Treatment Options for HSDD

The good news is that there are effective treatment options available for women struggling with HSDD and hopefully more on the horizon. Treatment approaches may include:

1. Hormone Therapy: For some individuals, hormone replacement therapy (HRT) can be beneficial, particularly if hormonal imbalances are contributing to their low sexual desire. Testosterone specifically is approved for postmenopausal women suffering from HSDD.
2. Psychotherapy: Counseling or therapy, such as cognitive-behavioral therapy (CBT), can help address underlying psychological issues contributing to HSDD.

3. Medications: Certain medications, such as flibanserin (Addyi) and bremelanotide (Vyleesi), have been approved to treat HSDD. These medications can help increase sexual desire when used as prescribed.  Viagara or Cialis can often be used for low libido as well in smaller doses then male doses. This method may be effective in women who suffer from low libido from SSRI’s or antidepressants.
4. Lifestyle Changes: Improving overall well-being through lifestyle changes, such as managing stress, getting regular exercise, and adopting a healthy diet, can positively impact sexual desire.
5. Relationship Counseling: If relationship issues are a contributing factor, couples therapy can be beneficial in addressing communication and intimacy problems.

Conclusion

Hypoactive Sexual Desire Disorder is a real and challenging condition that can significantly impact an individual’s life and well-being. It’s essential to recognize that HSDD is a medical issue, not a personal failing, and seeking help is a proactive step toward improving one’s sexual health and overall quality of life. With the right approach and treatment, it is possible to address HSDD and rediscover a fulfilling and satisfying sex life. Breaking the silence and stigma surrounding HSDD is a vital step toward helping women get the support and care they need.

Polycystic Ovarian Syndrome is a common cause of hormone irregularity in women. The most common signs of PCOS are hirsutism (think hair growth on women’s chins), irregular cycles and polycystic ovaries on ultrasound. It effects 5-10% of women. The health issues of PCOS run much deeper than acne and extra hair growth. Women with PCOS are at an increased risk for glucose intolerance, cholesterol problems, fatty liver, sleep apnea, mood disorders and obesity.

PCOS Diagnosis

PCOS can fortunately be diagnosed rather easily, though it can take many women years to pin down a proper diagnosis. History or irregular periods (usually less then 9 per year), hirsutism (thick pigmented body hair in a male distribution, and acne can be enough to diagnose. Labwork can certainly support the diagnosis as well specifically serum total testosterone is typically elevated. Labwork to rule out other possible endocrine diseases may be needed as well. Since metabolic health can be severely compromised in PCOS, checking lipids, apo A/B, Ha1c and liver numbers is beneficial.

Treatment Options

Spironolactone is a mild diuretic that has activity against androgens helps balance the hyperandrogenic signs of PCOS and thus improve acne and extra hair growth. For regulating cycles, a progestin IUD can be beneficial. Progesterone cyclical can be beneficial- taken every 1-2 months for 10-14 days. Shepherd’s Purse extract used every 4 hours as needed for heavy bleeding days is a nice, natural way to decrease bleeding. Metformin is commonly used to decrease the liver from making glucose and therefore decreasing insulin release from the pancreas. If on metformin, its advised to take a B12 supplement as metformin tends to block absorption of B12. Other recommendations for PCOS management are DIM 300-600 mg, Chaste Tree Berry , inositol, NAC and a daily Vitamin D. Supplements like Berberine can also be beneficial for PCOS women as it may help steady blood sugars and prevent insulin resistance.

Reduce Inflammation

PCOS takes a toll on the body. To combat this physiologic stress, following a low inflammatory lifestyle can be helpful. Omega 3, chia seeds and Curcumin are known inflammation reducers. Eating a low inflammatory diet can be very beneficial too- lots of salmon, fresh leafy greens, nuts, beans, 35 grams of fiber. Avoiding inflammation is key too! Cut out processed food, artificial sweeteners, alcohol, dairy, highly processed meats (lunch meat, sausage), any smoking or vaping.