Hyposexual desire disorder (HSDD) or low sexual desire in women affects about 1 in 10 women globally. The causes of low sexual desire in women are varied and many. The main causes I have seen in my practice are due to oral contraceptives, intrauterine devices, implantable hormonal devices, occupational/life stress, anxiety/depression, and psychiatric medications.
Unfortunately, obesity also plays a huge role in low sexual desire in women. Obesity is a chronic inflammatory state and can cause hypertension, heart disease, kidney damage, and diabetes. One of the main side effects of medications used to treat the aforementioned diseases is low sexual desire. So it is absolutely important to maintain a body mass index of 25, and a waist circumference of 35 inches in women. Additionally, obesity can be responsible for polycystic ovary disease (PCOS) and infertility.
The most important systems to be optimized are endocrine such as thyroid/parathyroid levels, a circulatory system such as hemoglobin level, and vitamin B/D levels. Optimization means that levels should be above the 50th percentile, sometimes even closer to the 100th percentile. The level should be titrated to how the patient feels relative to the improvement in symptoms.
The main treatment for low sexual desire is dietary/lifestyle change. The diet that is normally recommended for low sexual desire in women is the Mediterranean diet. It is important to make sure that this diet has organic components since regular food has a lot of hormones/steroids, antibiotics, and fertilizers/dioxins.
Medications that are available to treat low sexual desire in women are few. The drug that works really well after any underlying medical conditions are stabilized or resolved, and the aforementioned optimization of systems achieved is Addyi. Addyi can take up to 8 to 12 weeks to start working, the shortest time frame I have seen in my practice is 2 to 3 weeks, and I advised the patient to discontinue her oral contraceptive prior to starting Addyi. Once underlying medical conditions are stabilized, Addyi can be effective 70 percent to 90 percent of the time, otherwise, it is only 10-20 percent effective.
Telemedicine/Telehealth is a methodology for facilitating the delivery of women’s health and should be utilized frequently to improve the care of women globally. Low sexual desire in women is easily eradicated with Telehealth/Telemedicine as a modality for the delivery of women’s healthcare.