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Happy Couple

Low Libido/HSDD

What is HSDD?

Sexual desire may vary from person to person and time to time. It's completely normal to have fluctuating libido. HSDD is when low libido persists for six months or more. Approximately 1 in 3 women suffers from HSDD. Most women disregard it as a sign of normal ageing. If the low libido is not causing any distress in you or your partner then there is no need for concern. But if it's causing distress and relationship issues then you should talk to your physician.

Do I have HSDD?

HSDD is when the following symptoms persist for 6 or more months:

  • little to no interest in sexual activity

  • few to no sexual thoughts or fantasies

  • disinterest in initiating sex

  • difficulty getting pleasure from sex

  • lack of pleasurable sensations when the genitals are stimulated

What causes HSDD?

Once diagnosed we can find a cause for HSDD. It can be caused due to physical, psychological or a combination of both. We have listed a few common causes here:

  • thyroid disorders

  • diabetes

  • depression

  • anti-depressants especially SSRIs

  • painful sex: read more about it here

  • anorgasmia: read more about it here

  • imbalance in the brain neurochemicals

  • low levels of estrogen/testosterone

  • post pregnancy and during breastfeeding: during this period estrogen levels are low, thus reducing the libido.

  • menopause/ageing: menopause/ageing can lead to low libido because of vaginal dryness, low estrogen, low testosterone, arthritis and other medical issues.

  • psychological issues

relationship issues

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What should I do?

Get evaluated for the above causes. A simple examination and a panel of blood tests should help in finding a cause. Once a cause is found we can focus on treating the cause.

Treatment

Treatment is dependent on the cause, such as:

  • correcting thyroid problems if any

  • keeping your blood sugars in check

  • Replace your SSRIs with different anti-depressants.

  • If stress and fatigue are the cause then having a dedicated time for intimacy should help.

  • If depression/anxiety are causing low libido then seek the help of a psychiatrist

  • Low libido due to low estrogen/testosterone/menopause/ageing can be treated with hormone supplements. Usually, an estrogen containing cream or gel is sufficient to improve vaginal health and libido.

  • For relationship issues talk to a marriage counsellor.

  • Lastly, two FDA approved medicines can be used to increase libido in women. Flibanserin (Addyi) is a tablet that when taken daily can lead to a modest increase in libido.

Bremelanotide (Vyleesi) is a subcutaneous injection taken 45 minutes before sexual intercourse.

Both the drugs have modest efficacy and come with their own set of side effects.

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