Treating Low Libido in Premenopausal Women

Hypoactive Sexual Desire Disorder (HSDD) is the persistent or recurrent lack of spontaneous desire to initiate or participate in sexual activity. This condition is marked by sexual distress (i.e., feelings of frustration, low confidence, sadness, grief, etc.). HSDD has subtypes: acquired (developed only after normal sexual function), lifelong (present at the start of sexual function) generalized (not limited to certain situations or partners), and situational (limited to specific circumstances or partners). Approximately 10% of premenopausal women in the United States have HSDD.

HSDD must be present for at least 6-months for a formal diagnosis, but luckily there are a few treatment options:

1. Vyleesi (Bremelanotide)

Vyleesi bremelanotide is the first and only FDA-approved treatment for premenopausal women with acquired, generalized Hypoactive Sexual Desire Disorder. Vyleesi comes with an easy to use auto injector that women use to self administer the drug in their stomach area or thigh. Patients can take it at any time of the day at least 45 minutes before sexual activity. It shouldn’t be used to treat menopausal women with HSDD, to improve sexual performance, or for men or youth. Patients with high blood pressure or known heart disease shouldn’t take Vyleesi. The side effects of Vyleesi may include darkening of the skin in certain parts of the body, such as the face, gums, and breast, as well as nausea, nasal congestion, headache, fatigue, and dizziness. Talk to your provider regarding your HSDD symptoms and whether Vyleesi is the right fit for you.

2. Wellbutrin

There is evidence that the antidepressant Wellbutrin may be able to boost low libido in premenopausal women. Dr. Harry Croft, a psychiatrist and sex therapist, based in San Antonio, TX, conducted a 12-week preliminary study of 66 women, most of whom were premenopausal. He reported the findings at the 2000 American Psychiatric Association meeting. None of the women in the study reported depressive symptoms when the trial began. Still, they all had trouble becoming aroused or having orgasms. After the trial, 39% of the participants reported being satisfied with their levels of sexual desire. Wellbutrin side effects include dry mouth, insomnia, headache, and vomiting. It can also have the opposite effect and decrease libido. Wellbutrin isn’t an approved treatment for HSDD, but may be an option you and your doctor can consider.

3. Herbal remedies

Dozens of nutritional supplements claim to enhance women’s libido. Two of these supplements, ArginMax and Zestra, went through double-blind, placebo-controlled trials. The ArginMax trail documented that the supplement appeared to have a positive effect on women’s libido and helped them be more satisfied with their sex lives. It is typically safe for women to try herbal supplements on their own. Still, always speak to a doctor first. Some ingredients may negatively impact other medications you may be taking.

HSDD is a common and treatable condition. The key is open communication between women and their doctors. If you have concerns about your sexual desire, make an appointment with your doctor as soon as possible. Don’t suffer in silence. Help is available.

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