Amused young African American couple sitting and hugging

Amused young African American couple sitting and huggingAs most of us know, a great relationship doesn’t start and end with sex. But a healthy sex life does form an integral part of it. In fact, almost 80% of men and 66% of women view sex as important to their relationships. And research shows that when one’s sex life is assessed as “good”, it adds 15-20% positive value to a relationship. But when one’s sex live is reported to be “bad or non-existent”, it plays an inordinately powerful negative role, draining the relationship of its positive value, by 50-70%!

And for the critics out there, it’s important to note that sex isn’t just physical. It’s an opportunity to express feelings that words cannot … an emotional experience that brings you closer with your partner … and, for some, the ultimate expression of their love. Not only does it foster a unique closeness, it can also provide comfort in times of stress, anxiety or other troubles. And it can help to keep things fresh and exciting, as couples “rediscover” each other through varied forms of sexual expression.

Timing and Frequency
Unfortunately, “importance” can be very subjective. While one person might view daily sex as crucial, another might think they’re doing a pretty good job fitting it in once every week or two. As long as a couple is on the same page, there are typically no problems. If it works for both of you, great! It’s when there is a difference in opinion that problems begin to arise.

Sex Drive Compatibility
If one person has a higher sex drive than their partner, they can start to feel unfulfilled. The other partner may wonder what the big deal is. (“Come on, it’s just sex!”) But for the unfulfilled partner, it can be a huge deal. They may begin to feel unwanted or unloved, and may even turn to sex substitutes, such as food, alcohol, drugs, even infidelity. Or they may just become angry and resentful. As a result, the relationship starts to suffer on all levels, which in turn, leads to even less sex, thus perpetuating a vicious cycle of conflict.

Making Time
The key to a healthy sexual relationship is often compromise – whether you’re the one who occasionally has sex when you’re not in the mood, or the one who goes without for a few days. Another key is being proactive – trying new things in the bedroom, seeking counseling, or simply making time for sex. There are a number of things that can slowly but surely erode your sex life – from busy schedules and kids to aging/changing bodies and lack of communication – but if you make sex a priority (instead of letting it become the white elephant in the room), you can keep the passion alive and your relationship healthy.
Interested in women’s sexual health? Contact us for an appointment.

I’m pleased to share with you some exciting news about a treatment for low sexual desire that has an unintended consequence you may actually appreciate–weight loss. Some patients reported that after using flibanserin for as short as 8 weeks, that they began noticing that their clothes were looser and the number on the scale was surprisingly lower. Sounds too good to be true, I know, but let’s take a look at what flibanserin is and how it affects the brain.  Flibanserin is a serotonin 1A receptor agonist and a serotonin 2A receptor antagonist, which influences biological and neurological processes. While its primary effect is to increase sexual desire, it also has an impact on anxiety, appetite, memory, mood, and sleep. Researchers found that this treatment reaches the part of the brain that experiences sexual desire, but it may also impact satiety, that feeling of fullness at the end of a meal. Unlike some weight loss medications, there appears to be no weight regain with flibanserin (at least for about 18 months of study). More research will help us learn more about these effects, both sexual desire and weight, over the long term, but this is considered clinically meaningful in my book.

Flibanserin was first approved by the Federal Drug Administration (FDA) in August 2015 for low libido in women and was immediately dubbed the “female Viagra” although that is a misnomer.  Viagra treats a blood-flow issue to the penis, a physical issue, not desire which is an issue of the mind. For most women, sexual desire starts “north,” in the brain.

The Science Behind Improving Sexual Desire
Flibanserin was originally created as an antidepressant and although it didn’t work very well for depression, patients noted a pleasant side effect, an increase in sexual desire. It went back to the lab for further research, leading us to this moment in a new sexual revolution for premenopausal women. Considering that many women experience sexual dysfunction at some point, it is worth going for an evaluation with your doctor, ruling out extenuating circumstances (i.e., relationship problems), and see if this loss of desire is an actual diagnosable disorder, hypoactive sexual desire disorder or HSDD. If it is there is a solution.

Optimal Timing and Dose
The effectiveness of the 100 mg bedtime dose of flibanserin was evaluated in three pivotal 24-week trials of 2,400 premenopausal women with hypoactive sexual desire disorder (HSDD), otherwise known as “not ever in the mood for sex…ever!” The average age of women in the trials was 36 years, and these women had experienced diminished sex drive for about five years. While many have said that this medication only works in a small percentage of patients, and only has a little benefit at that, our experience is that those who respond do so in 8 weeks, and really recognize the difference. However, flibanserin has not been shown to enhance sexual performance in normal women, but it’s a starting point for women who have not been able to put a name to their low sexual desire condition, or have not found an effective treatment.  Additional treatments such as vaginal estrogen and or testosterone may be used for physical issues such as vaginal dryness or pain with intercourse.

Flibanserin is not without some side effects such as dizziness and in a few cases, lower blood pressure. But taken as directed, specifically, at bedtime, and without alcohol, you may be in for a satisfying sexual experience and some weight loss, which you will be thankful for all year long.

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