Are Drugs the Best Way to Restore Her Sexual Desire?

Western cultures instinctively look to pills to cure whatever ails them. This partially explains the tremendous success of Viagra in treating male erectile dysfunction.

Women, of course, don't suffer from erectile dysfunction, but often do suffer from female hypoactive sexual desire disorder (FHSDD), a lack of sexual desire.

Viagra does little in treating FHSDD, but the search for a cure for FHSDD in the form of a pill has been ongoing.

The new leading contender is flibanserin, developed by the German firm Boehringer Ingelheim. The drug is part of the large class of drugs that treat depression, such as Prozac, Zoloft, and Welbutrin.

In fact, flibanserin was originally created to treat depression, but was found to be ineffective in that capacity. Drugs that treat depression do so by raising levels of chemicals in the brain called neurotransmitters.

Dopamine, serotonin, and nor-epinephrine are the three neurotransmitters that are commonly manipulated. Flibanserin has been found to increase levels of domamine and serotonin in the brain.

Fluoxetine (Prozac) and sertraline (Zoloft) work primarily in the brain to increase levels of serotonin. One of the numerous side effects of these drugs is to decrease female sexual desire.

Although the side effect of decreased sexual desire is a concern for many women on these drugs, I have found that very few will stop them for this reason.

The beneficial effects of the medication on depression, panic disorders, and overall well being are in general a benefit that outweighs the loss of sexual desire.

This leads me to the antidepressant, bupropion (Welbutrin). Bupropion raises levels of dopamine and nor-epinephrine in the brain, and like flibanserin, has the effect of increasing sexual desire in females.

In my practice I have had modest success in using Bupropion to treat FHSDD. The problem with Bupropion is that it is not tolerated all that well by many patients.

Bupropion in high doses has long been known to increase the risk of seizures, and in low doses (all that are used now) will lead to feelings of agitation.

Less common side effects are weight loss and insomnia. Many women on bupropion tell me they don't like the way that they feel.

Flibanserin, has been shown to have a modest positive impact on sexual desire, arousal, and has demonstrated an increased incidence of pleasant sexual activities.

Side effects appear to be significant, with 15 percent dropout rates in trials. Effects of flibanserin are not immediate, but may be long lasting.

Flibanserin is primarily for premenopausal women, with hormone replacement therapy and testosterone being a better choice for postmenapausal women.

Being a westerner, and a physician to boot, I am naturally inclined to consider pills the best solution for all our problems.

Flibanserin may be helpful in jump starting sexual desire, but when you get down to it, FHSDD is a psychological disturbance and not a chemical imbalance.

Adjusting the brain's chemistry to compensate for deficiencies in a relationship is not the best line of attack for this problem.

For those of you who don't believe that FHSDD is primarily a psychological problem; consider the widespread finding that a woman with FHSDD who has found a new relationship, will almost always have a sudden soaring sexual appetites. This comes from the unconscious fulfillment of her true sexual desire.

The best way to restore sexual desire is accomplished by understanding what her true sexual desire is, and by finding ways that it can be fulfilled.

This is all that she needs to release the required neurotransmitters. Forget the pills and start concentrating on your relationship.

By : Michael_A_Shaw,_M.D.