Low sexual desire (libido) is a common type of sexual dysfunction in women and can be challenging to treat.
Sexual dysfunction can refer to difficulties in libido (sex drive), arousal, or orgasm. There are many causes of sexual dysfunction. Psychiatric conditions such as depression or anxiety or emotional distress from work or relationship stressors are common causes. Some medical conditions can also affect sexual function, such as heart disease, certain neurological conditions, arthritis, or hormone changes during menopause. Medications, especially antidepressants, can also cause sexual dysfunction. Addressing the underlying medical or psychological issues improves sexual function in most women.
However, some women who have no other medical or psychological concerns still have low sexual desire that affects both their personal and relationship well-being. This condition is referred to as female sexual interest/arousal disorder. This is a new diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), which combined the previously separate disorders of hypoactive sexual desire disorder (HSDD) and female sexual arousal disorder. The prevalence of these disorders varies widely depending on the population surveyed, but studies have suggested it can range anywhere from 5% to 15% of women. Treatment of HSDD and female sexual arousal disorder can be challenging.
In August 2015, the US Food and Drug Administration (FDA) approved a medication called flibanserin to treat HSDD in premenopausal women, making it the first FDA-approved medication for low sexual desire in women. It is anticipated to be available in the United States in October 2015. Flibanserin works by interacting with certain receptors for serotonin, a neurotransmitter that has a role in regulating mood, sleep, digestion, and many other functions of the body. The exact way in which flibanserin leads to improved sexual desire in women is not clear, but studies have shown that it has a beneficial effect in women diagnosed as having HSDD.
Flibanserin can have serious side effects, including low blood pressure and fainting. The risk of these side effects increases with alcohol use, so alcohol absolutely cannot be combined with flibanserin. Other medications including some birth control pills and antifungal agents can also increase the risk of these side effects. Women with liver problems should not take flibanserin.
Because of these potentially serious side effects associated with alcohol use, not all doctors or pharmacies will be able to prescribe or dispense flibanserin. Because flibanserin is a new medication, continued postmarketing data collected by the FDA will be important. In the meantime, the FDA encourages the development of new drugs to treat female sexual disorders given the continued need for effective treatments.
American College of Obstetricians and Gynecologistswww.acog.org/-/media/For-Patients/faq072.pdf
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at www.jama.com. Spanish translations are available in the supplemental content tab.
Sources: Kingsberg SA, Rezaee RL. Hypoactive sexual desire in women. Menopause. 2013;20(12):1284-1300.
Gellad WF, Flynn KE, Alexander G. Evaluation of flibanserin: science and advocacy at the FDA [published online July 6, 2015]. JAMA. doi:10.1001/jama.2015.8405.
Topic: Women’s Health
Jin J. Flibanserin for Treating Low Sexual Desire in Women. JAMA. 2015;314(12):1312. doi:10.1001/jama.2015.11769