For Sexual Dysfunction, 'Men Get A Pill And Women Need Therapy.' What Gives?

Melanie says she loves her partner of four years and that she's physically attracted to him. She just hasn't wanted to have sex with him for the past three years.

"It's very frustrating being somebody who used to be so interested in sex and having such a voracious sex life only to not," Melanie, a 27-year-old student in Canada, said. "It affects my self-esteem. It affects my day-to-day existence."

Melanie spoke candidly to The Huffington Post about intimate details of her personal life on the condition that her real name not be used.

This loss of desire came after taking antidepressants to treat a misdiagnosis of anxiety disorder and depression. As the medication took effect, Melanie's libido dropped and her sex life pretty much ceased to exist. She eventually weaned herself off the medication with the help of her doctor, but her sex drive never returned.

Luckily, Melanie's partner has been willing to work through this issue with her. They practice sensate therapy exercises that allow them to touch each other without the expectation of sex, and through therapy, Melanie has been able to understand that her difficulty with intimacy doesn't mean she's not "good enough" for her relationship.

All of this is progress, but Melanie wants her sex drive back.

She isn't alone. In a 2008 study, 26.7 percent of premenopausal women and 52.4 percent of menopausal women in the U.S. reported low sexual desire. And currently, there's no FDA-approved drug to treat low libido in either men or women.

It's important to point out that disorders associated with low sex drive aren't doling out pathology to preference. Not wanting to have sex is only a problem if you want to want it.

A proposed drug claims to offer women a solution, but it comes with controversy.

In 2014, there was a lot of press about flibanserin, a drug that was created to treat low libido in women. It's supposed to target the neurotransmitters involved with low sex drive, rather than altering hormones (like testosterone therapy) or blood flow (like "female Viagra"). It was submitted for FDA approval in 2013, but was turned down so that the pharmaceutical company could do additional research. Sprout Pharmaceuticals, the company behind flibanserin, announced last week that it had resubmitted the drug for FDA approval.

Medication can't address situational causes for low libido, like a bad relationship or stress, but Sprout Chief Executive Officer Cindy Whitehead said it can help women whose low sex drives are related to their brain chemistry. She said she's not trying to impose some idyllic barometer of sexual desire, but rather, she wants to help women return to their "normal" amount of sexual activity -- if they want to, that is. She also noted that sex drive is something that generally fluctuates throughout a woman's life.

"It's a nightmare for women who are in a relationship, who aren't the person they used to be and want that person back," Irwin Goldstein, director of the Sexual Medicine Program at Alvarado Hospital in San Diego, told HuffPost. "The unmet medical need for this condition is great and the choices available to women are limited."

Goldstein, one of the original researchers for Viagra, has worked with female sexual dysfunction for the past 17 years. After Viagra was approved in 1998, his office received a barrage of phone calls from women asking if he had a solution for them, too. Until 2009, when fMRI studies showed that there are actual biologic differences in the brains of women with and without low desire, Goldstein didn't have many leads. He now advises over a dozen pharmaceutical companies, including Sprout, and treats women suffering from low desire in his practice daily.

But some people question why so many women feel their sex drive is inadequate in the first place. Media culture frequently hypes up sex and stigmatizes the lack of desire, and some argue that adding medication to the mix will only water down the complex issue.

"Medicalizing takes one little piece of the picture and says, 'That's what the picture is,'" Leonore Tiefer, a clinical associate professor of psychiatry at the New York University School of Medicine and an activist who runs a campaign against medicalizing sexuality, said. "It's a matter of 'normal' and 'abnormal' and 'function.' It’s like saying, 'Square dancing is what dancing is and all of these other things are not the heart of the matter.'"

There are experts who fall somewhere in the middle, too. Lori Brotto, an associate professor in the Department of Obstetrics and Gynecology at the University of British Columbia, told HuffPost that she thinks some women with low desire could benefit from medication or a combination of medication and talk therapy.

"I don’t think the science is there yet in terms of being able to say definitively that these neurotransmitters act in this way to cause this individual woman's low desire," Brotto said. "I think eventually we'll get there, though."

But the question remains: Do women even want their own 'little pink pill'?

There's not a clear-cut answer, but it seems that women overwhelmingly want choices. Whether or not flibanserin is the pill that will do the trick, many women would like to know that they have the option of medication available to them if there is science to support it.

In October, the FDA invited women suffering from sexual dysfunction to talk about their experiences during a two-day patient-focused workshop that will hopefully provide the federal agency with information on what role it should be playing. (Four of the eight women on the panel were patients being treated by Goldstein.) Listening to women just might help everyone involved wade through the political trenches of the issue.

On the HuffPost Women Facebook page, we asked our community members if they wanted a sexual dysfunction pill. Overall, the sentiment among the 503 commenters was: Why aren't we doing more to find a safe medical treatment?

"I just find it ironic that men get a pill and women need therapy," one woman wrote.

That said, many women have reservations about taking on the risks of medication, especially since low libido is often at least partially caused by situational factors.

Even if not every woman who struggles with libido is willing to take a pill, it's hard to deny that the need for treatment is there. "I'd love [medication]," wrote one woman on Facebook. "I've lost a lot of that drive -- I'm in my 30s mind you. It's so frustrating and sad."

For now, Melanie and women like her can rely on therapy to help them inch their way back to the sex lives they once had. It's up to the FDA to decide if pills like flibanserin are the answer, but there's clearly a need for more dialogue around the issue. Life without sexual desire is something many people just aren't willing to accept.

"It's not just prudishness," Melanie said. "It's a real problem. I'm just trying to get my life back."



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