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Intimacy Issues in Your Relationship Can Include More Than Your Realize


It may seem embarrassing for women to address this issue – but it shouldn’t be – problems in an intimate relationship can be caused by many factors – one of which women may not even have much knowledge about.


Avoiding sexual intimacy and feeling frustrated as a result can lead to self-esteem issues and cause problems in your relationship.


If this sounds familiar to you, you need to know you’re not alone. These may be symptoms of a common and treatable health condition, called hypoactive sexual desire disorder, or HSDD.


One in ten women in the U.S. are estimated to have HSDD, a medical condition characterized by low sexual desire that causes a woman personal distress. That’s roughly the same percentage of women who have diabetes! While many women haven’t heard of the condition, it’s been known to the medical community for decades.


HSDD can make women avoid intimacy, leading to self-esteem issues and stress in their relationships. While it’s natural for women’s sexual desire to rise and fall over time, HSDD is different; it is biological and not a result of issues or unhappiness a woman may experience with their partner.


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Many women are too embarrassed to tell their healthcare provider about this problem, but it’s nothing to be shy about. It’s something to learn about, and talk about with a health care provider. HSDD is a condition that can be handled with the proper care and treatment, if appropriate.


Dr. Alyssa Dweck, a New York based practicing gynecologist specializing in female sexual health and medical sex therapy joined me to share more about the condition, as well as available treatment options.




What are some reasons why some women may experience intimacy issues and feel less desirous?


Dr. Dweck: There’s a big difference between those women who have a temporary drop in their desire, maybe because they’re stressed out at work or maybe because they’ve had a little spat with their partner, but there’s a subset of women, approximately 1 in 10, as you mentioned, of premenopausal women who suffer from an actual medical condition called HSDD, hypoactive sexual desire disorder. This is a specific medical condition marked by a plummet in desire and also distress associated with this lack of desire.

This [medical condition] can take a significant toll on women. It alters their self-esteem, it alters their body image, and it also takes a toll on their intimate relationships. So, it’s really important to distinguish HSDD from other causes of low desire.




Absolutely. Now, what are some ways that women can distinguish HSDD from other causes of low desire?


Dr. Dweck: There are certain questions that we typically ask when we’re trying to decipher this. For example, there are medical conditions that might alter desire. There are also medications that might bring down women’s desire. Relationship issues are super common in terms of altering desire as are psychiatric conditions, but HSDD specifically has none of these variables and it’s probably more of a chemical issue going on in the brain.



What can indicate to a woman that, as you said, that there really may be something more serious going on and it’s time for me to go see my healthcare provider?


Dr. Dweck: Well, I think that the distress that this causes is really the cause for women to seek assistance. The other thing is we need to give information.

Some women feel embarrassed or uneasy bringing up the conversations regarding intimacy to their healthcare providers and that has to change. Who’s better poised to have this discussion with women than their gynecologist, who’s really been speaking about vulnerable and intimate issues throughout their life cycle? By the same token, some healthcare providers need to take the time in their busy schedules to elicit this information and make it a topic of conversation. So direct conversation is probably most valuable.



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In the conversation with healthcare providers, what is kind of a checklist that women can take with them in order to bring that conversation up in a comfortable manner with their provider, especially if their providers not the one who’s initiating that conversation?


Dr. Dweck: [On the] Vyleesi.com website, there’s a questionnaire that really outlines questions that might lead people to think that they are suffering from HSDD or they may be having a lower desire for another reason. So, this is a really important tool that women can use and then bring themselves to their healthcare providers armed and ready to ask the appropriate questions.




How is HSDD treated?


Dr. Dweck: We are so lucky because HSDD has actually been in the medical conversation for decades already, but it wasn’t until a couple of years ago that it really became more of a conversation when the FDA made some treatments available. Vyleesi, bremelanotide injection is the first and only ‘as-needed’ FDA approved treatment for HSDD. This is a melanocortin receptor agonist that works in the brain and it’s indicated for acquired generalized hypoactive sexual desire disorder. Vyleesi is really unique because it is used as needed – in other words, it’s taken in anticipation of intimacy rather than as an everyday medication. So this is quite novel.



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Side effects that are most common include nausea, also flushing, injection site reactions, headache and vomiting. Additionally, Vyleesi is contra-indicated and women with uncontrolled hypertension or known cardiovascular disease.




If there’s an estimated 1 in 10 women that have this condition and you said it’s been in the conversation for a very long time, why are so many women unaware of it?


Dr. Dweck: Well, I’m glad you’re raising awareness, for example, of this condition. I think most women were suffering somewhat silently, feeling concerned and uneasy about bringing up the conversation, but now that it’s more on the forefront, women are more educated about it and hopefully will not feel shy about bringing it up with their healthcare providers. Healthcare providers are also getting educated on this and so it’s definitely more common to speak about.



In addition to Vyleesi, which sounds like a wonderful way treat HSDD, is there anything that women can do in terms of healthy lifestyle changes that they can make to better help with HSDD symptoms?


Dr. Dweck: I think a healthy lifestyle that involves a healthful diet. I typically recommend the Mediterranean diet as a lifestyle rather than using a crash diet. I think that’s quite helpful because after all, if you feel good about yourself, your intimate wellness will also be better.


Intimacy Issues in Your Relationship Can Include More Than Your Realize womens health


I always advocate exercise, cardio and weight training type of exercise, especially in those perimenopausal years when it’s so easy to start gaining weight. I also recommend stress reduction. We have to take that into account, especially for today’s woman who is so busy multitasking and has loads of different responsibilities.

Intimacy Issues in Your Relationship 

Wife. Mom. Believer. Writer. Advocate.

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