Low libido one of the most common problems presented in sex therapy. It is estimated that approximately 20 per cent of men and 33 per cent of women are affected by low or absent sexual desire.
But in trying to seize an opportunity are drug companies selling a product that women don't need?
Why do pharmeceutical companies want to 'help' with female low libido?
Although there isn't anything inherently wrong with drug companies wanting to help women with a low libido, we do need to understand their motivation.
There is a race by the drug companies to get a female libido enhancing 'pink Viagra' to market. Of course it could mean billions of dollars in shareholder profit. In the long line of attempts over the years Boehringer Ingelheim developed Flibanserin; however, the drug company dropped efforts in 2010 after being declined by the FDA who requested more research.
A smaller drug company, Sprout, took the work over in 2011. They resubmitted an application and were once again declined by FDA. However in the mean time there have been many credible news outlets citing a condition called: hypoactive sexual desire disorder or HSDD. Although purely speculation, it seems Sprout was doing the necessary behind the scenes PR before unveiling its new drug.
HSDD is no longer a 'real condition'?
May 2013 The Diagnostic and Statistical Manual of Mental Disorders or DSM 5 changed the diagnosis of low libido. It replaced "hypoactive sexual desire disorder" with "sexual interest/arousal disorder". A big reason it was replaced is the condition of HSDD had too broad a definition, "An absence of sexual fantasies and desire for sexual activity." As well, the HSDD model was derived from studies on predominantly male subjects.
Has the terminology changed but the thinking around HSDD stayed the same?
HSDD was based on a linear male model, stating desire precedes arousal in the form of fantasizing, yearning, and looking forward to the experience -- a.k.a. 'spontaneous' desire. The challenge with this 'spontaneous desire' framework is it is infrequent in many functional and satisfied women, especially those in established relationships.
For many women arousal is responsive, occurring at some point after she has chosen to engage in the experience. Moreover, studies confirm women mostly accept or initiate for reasons other than desire: for example to increase the couple's emotional bond, or as a response to a romantic setting.
Which calls into question: is the estimated number of women with a 'desire disorder' really accurate because we still expect women to have 'spontaneous desire' rather than 'responsive desire'.
Have the pharmaceutical companies over diagnosed low libido by relying too heavily on the condition of HSDD?
In 1998 when Viagra came on the scene, it was a credible product because it helped male sexual dysfunction. Drug companies knew they needed a female sexual dysfunction condition to credibly sell her a product. Which is why they ran with the HSDD model.
There are many desperate women who would love after an endless day of work, taking the kids to soccer, making supper and cleaning up, to simply take a pill and be in the mood for sex. Currently, non-FDA approved libido enhancing drugs are a major dollar industry.
In trying to seize this opportunity what we see from drug companies are well orchestrated marketing blitz which has little to do with science. Even though no data has been released and no breakthroughs have been discovered, what the public hears through news releases is: women with a lack of desire suffer from emotional distress, and it is a common crisis within their relationship.
What we need to ask is: why are drug companies investing heavily in research, surveys and patient registries to indicate there is a disorder, while at the same time creating medication to treat this condition.
But a lack of desire is a big couple contentious issue
Sexual desire is elusive and a difficult thing to define. Lack of libido is not a simply a checklist of things and if you check all the boxes you can be prescribed medication.
Many women and men do report dissatisfaction with sex, but that does not mean they are dysfunctional. More likely it is due to a variety of interrelated factors be it physical, psychological and social.
A smaller percentage of men and women do experience sexual problems causing them distress, discomfort and dissatisfaction. Although they need attention it is neither a clinical condition nor dysfunction, and it is wrong for the drug companies to manufacture a precondition.
What are some every day things that can affect a women's libido?
Because there is so little factual sex ed in our society, we are instead bombarded with Cosmo type titillating articles about how to improve your sex life. It leaves the majority feeling that if you have low libido you are abnormal. When in truth, there are so many obstacles getting in the way to feel spontaneous or even responsive desire.
Something as simple as: if you've had a fight in the morning, chances are no nookie will happen that night. Did you just have a baby? Are you in peri-menopause or menopause?
Other things that heavily contribute are: Do you have good communication with your partner? Do you have a healthy sexual self-esteem? What were messages in your upbringing?
There are also external things like: Birth control pills, antidepressants, allergy meds, alcohol, high cholesterol, thyroid problems. Also chronic sleep deprivation -- which affects many people -- messes with your hormones and hits your libido like a torpedo.
What is the bottom line on libido and libido-enhancing drugs?
The chances are slim that one day women can take a pill which will overcome the complex myriad of things that make up her will, want and desire to have sex.
Instead couples need to roll up their sleeves and talk about the plethora of different solutions/ options available. And also be aware by accepting a band-aid solution like a low libido pill thereby medicalizing sexual libido, it will only serve to restrict her sexual desire in the long term.
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