From the Guidelines
Treatment for hypoactive sexual desire disorder (HSDD) should prioritize a comprehensive approach, including lifestyle modifications, therapy, and medications, with flibanserin being a recommended option, as discussed in the 2016 NCCN Guidelines 1. When addressing HSDD, it is essential to identify and address underlying causes, such as hormonal imbalances, stress, relationship issues, or medication side effects.
- Lifestyle changes, including regular exercise, adequate sleep (7-9 hours nightly), stress management techniques, and limiting alcohol consumption, can naturally boost libido.
- Therapy, such as couples therapy or sex therapy, can address relationship issues affecting desire.
- Medications, including flibanserin (Addyi) 100mg taken once daily at bedtime, may be prescribed for women, as mentioned in the 2016 NCCN Guidelines 1.
- For men with low testosterone, testosterone replacement therapy in various forms (gels, patches, or injections) might be beneficial.
- Certain supplements, such as maca root, ginseng, or fenugreek, may also be considered, although evidence varies. It is crucial to allow several weeks to months for treatments to show full effectiveness and maintain open communication with a healthcare provider about progress.
- A discussion of available options, including a vibrator or clitoral stimulatory device, with referral to an appropriate specialist, is also recommended, as noted in the 2016 NCCN Guidelines 1.
- Ultimately, a comprehensive approach combining medical treatment, psychological support, and lifestyle changes typically yields the best results for individuals with HSDD.
From the FDA Drug Label
ADDYI is a prescription medicine used to treat hypoactive (low) sexual desire disorder (HSDD) in women who have not gone through menopause, who have not had problems with low sexual desire in the past, and who have low sexual desire no matter the type of sexual activity, the situation, or the sexual partner. ADDYI is indicated for the treatment of premenopausal women with acquired, generalized hypoactive sexual desire disorder (HSDD), as characterized by low sexual desire that causes marked distress or interpersonal difficulty and is NOT due to: • A co-existing medical or psychiatric condition, • Problems within the relationship, or • The effects of a medication or other drug substance.
The treatment option for hypoactive sexual desire disorder (HSDD) is flibanserin (ADDYI), a prescription medicine used to treat HSDD in premenopausal women who have not had problems with low sexual desire in the past, and who have low sexual desire no matter the type of sexual activity, the situation, or the sexual partner 2.
- Key characteristics of HSDD: low sexual desire that causes marked distress or interpersonal difficulty, not due to a co-existing medical or psychiatric condition, problems within the relationship, or the effects of a medication or other drug substance.
- Important considerations: flibanserin is not indicated for the treatment of HSDD in postmenopausal women or in men, and is not indicated to enhance sexual performance.
From the Research
Treatment Options for Hypoactive Sexual Desire Disorder (HSDD)
- The primary treatment for HSDD in women is testosterone administration 3.
- Treatments that affect neurotransmitters and hormones that may be out of balance can help improve sexual desire in women with HSDD 4.
- The two primary approaches to treating HSDD are psychotherapy/sex therapy (individual or couples) and pharmacotherapy 5.
- Testosterone therapy is an option for the restoration of sexual drive, particularly in postmenopausal women 6.
- Transdermal testosterone administration may bypass the effects of first pass hepatic metabolism and has been shown to be effective in treating HSDD in surgically postmenopausal women receiving concomitant estrogen therapy 6.
- Testosterone supplementation has been prescribed for the treatment of HSDD in premenopausal women, as well as in those with naturally occurring or surgically induced menopause, although conflicting evidence and debate regarding the clinical efficacy of testosterone remain 7.
Pharmacologic Treatment
- There are no Food and Drug Administration-approved pharmacologic treatments for HSDD 5.
- Four investigational drugs are in mid- to late-stage clinical trial development for the treatment of HSDD 5.
- Testosterone products, including oral, injectable, and transdermal preparations, have been prescribed for the treatment of HSDD in women, although additional studies with longer follow-up periods are necessary to fully assess their efficacy and safety 7.