Decreased libido (diminished sex drive)

The medical term for decreased libido is hypoactive sexual desire disorder (HSDD). HSDD is one of the most common forms of sexual dysfunction in women. The essential feature of HSDD is a deficiency or absence of sexual fantasies and desire for sexual activity that causes marked distress or interpersonal difficulty. 

The evaluation of HSDD requires careful and thoughtful consideration of the patient and the multitude of factors (both psychological and physiological) that impact on the various components of adult female sexual desire. These factors may include relationship status, self-esteem, stress, menstrual cycles, hormonal contraceptives, other medications, postpartum states and lactation, oophorectomy and hysterectomy, and perimenopausal and postmenopausal states. The evaluation should also include an extensive hormonal blood workup including testosterone, sex hormone binding globulin and estrogen levels. HSDD can greatly impact a woman’s relationships and quality of life but effective treatment is available. 

Treatment

Optimal treatment of HSDD in women includes both a psychological and physiological approach. Counseling, lifestyle changes, behavioral activities, treatment of coexisting medical or psychiatric disorders, and switching or discontinuing medications that could impact sexual desire (SSRIs, hormonal contraceptives, anti-hypertensive medications) must be addressed. 

If a woman has low testosterone, supplementing with bio-identical topical testosterone gel or subcutaneous pellets can be very effective. If a woman is postmenopausal and experiencing hot flashes, night sweats and insomnia, estrogen can be supplemented with a patch, cream or vaginal ring. In addition, a new medication called flibanserin (Addyi) that works by modulating neurochemicals in the brain can be used to increase libido. Lastly, we use other medications such as oxytocin, buproprion, and Adderal that increase the pro-sexual hormones or neurotransmitters in the brain.  

Conditions we treat

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