Hypoactive Sexual Desire Disorder (HSDD) is a condition characterized by a persistent lack of sexual desire that causes personal distress or difficulties in relationships. It’s one of the most common sexual health concerns in women, especially those who are premenopausal, perimenopausal, or postmenopausal. HSDD is not just about having a low libido occasionally—it’s about ongoing low sexual interest that isn’t explained by other medical, psychological, or relationship issues.
Causes of HSDD
HSDD can be influenced by various factors, including:
- Hormonal changes (e.g., menopause, birth control, postpartum)
- Emotional or relationship stress
- Past trauma
- Medical conditions or medication
Diagnosis
A diagnosis of HSDD typically involves a detailed medical, psychological, and sexual history to rule out other causes. Your provider may use screening tools or questionnaires to assess desire and distress levels.
Treatment Options
1. Lifestyle & Counseling
- Sex therapy or counseling: Especially helpful if relationship issues, stress, or past trauma are contributing.
- Mindfulness-based therapy: May improve awareness and enjoyment of sexual experiences.
- Healthy lifestyle changes: Regular exercise, stress reduction, improved sleep, and reduced alcohol use can help.
2. Hormonal Treatments
- Testosterone therapy (off-label): May be considered in postmenopausal women to boost sexual desire.
- Estrogen therapy: Can help relieve vaginal dryness and improve comfort, which may support desire.
3. FDA-Approved Medications
There are two FDA-approved medications for HSDD in premenopausal women:
- Addyi (flibanserin): A daily oral pill that works on brain neurotransmitters to increase desire. It’s not for use with alcohol and may cause dizziness or sleepiness.
- Vyleesi (bremelanotide): A self-injected medication taken on demand (about 45 minutes before anticipated sexual activity). It works on the brain’s melanocortin receptors to help boost desire.
- How it’s used: Injected under the skin of the thigh or abdomen using a prefilled autoinjector.
- Side effects: Nausea, flushing, headache, and increased blood pressure in some users.
- Who it’s for: Premenopausal women with acquired, generalized HSDD—not due to other medical or psychiatric conditions.
Summary
HSDD is a real and treatable condition. A combination of counseling, lifestyle adjustments, and possibly medications like Vyleesi can help women regain sexual desire and improve quality of life. If you’re struggling with low sexual desire, talk to a provider experienced in sexual health—help is available HSDD is a real and treatable condition. A combination of counseling, lifestyle adjustments, and possibly medications like Vyleesi can help women regain sexual desire and improve quality of life. If you’re struggling with low sexual desire, and would like to discuss your options, schedule a “Sexual Medicine” consultation at our website (yourmenopausemd.com) or call our office at 918.924.5149.