- The Washington Times - Friday, January 22, 2010

How does it feel for a married woman to have low sexual desire? “It’s terrible,” says Kim, a California woman who has been treated for hypoactive sexual desire disorder (HSDD).

What’s worse, though, is having doctors say that having no interest in sex is not a big deal.

“Quit whining.” “A lot of women don’t have a big sex drive.” “You could have a lot worse things wrong.” All are all comments Kim (who asked that her full name not be used) has heard from doctors when she sought help for her utter and persistent lack of interest in sex.

Women like Kim are the potential client base of a product now under development by German drug maker Boehringer Ingelheim.

The new product, known as flibanserin, would be the first of its kind to help women who suffer from little or no sexual desire, said Dr. Irwin Goldstein, director of the Sexual Medicine Program at Alvarado Hospital in San Diego and a consultant to Boehringer Ingelheim.

Men have several products available to them for sexual dysfunction, but there is “not a thing available for women,” said Dr. Goldstein.

A drug like flibanserin “has the opportunity to change the history … of women’s health and, specifically, women’s sexual health,” he added.

In November, Boehringer Ingelheim presented the results of a 24-week, phase III clinical trial with 1,378 premenopausal women with HSDD. The women either took a daily dose of flibanserin or a placebo.

The flibanserin women had more sexually satisfying events per month (2.8 at baseline to 4.5 at study end), compared to placebo women (2.7 at baseline, increasing to 3.7 at study end).

Flibanserin was also shown to significantly increase women’s sexual desire and reduce their distress over sexual issues.

Flibanserin was discovered when researchers were studying a fast-acting antidepressant. While most antidepressants reduce people’s libido, this compound increased it.

The next step for flibanserin is a review by the U.S. Food and Drug Administration. No “public disclosures” have been made about a new drug application for flibanserin, a spokeswoman for Boehringer Ingelheim said.

However, Dr. Goldstein noted, the company was pleased with the trial outcomes.

Dr. Goldstein is no stranger to innovations in sexual health. Last year, he received the Gold Medal award from the World Association for Sexual Health in recognition of his lifetime contributions to the field, which include helping Pfizer develop Viagra in the 1990s. Viagra brings in about $2 billion in revenue worldwide, according to Pfizer.

A product for women’s sexual dysfunction has been sought as well, as about one in 10 women are believed to struggle with low sexual desire.

Marriage therapist Michele Weiner Davis, founder of DivorceBusting.com and author of several books, including the “Sex-Starved Marriage: Boosting Your Marriage Libido: A Couple’s Guide” and “The Sex-Starved Wife: What to Do When He’s Lost Desire,” is keenly aware of the misery sexual dysfunction can cause in a relationship.

However, she is cautious about “medicalizing” the problem, especially with women.

“In my several decades of working with couples, I’m here to tell you that low sexual desire in men and women is a very complex issue,” Mrs. Weiner Davis said.

If sexual desire were simply biological - tied to testosterone levels, for instance - then people with a lot of testosterone should have a high level of desire. But there’s no such correlation, she said.

Instead, there are likely to be a lot of factors in play, including biochemistry and psychological issues, such as body image, fatigue and stress.

Mrs. Weiner Davis prefers to start with the “least invasive intervention,” which means asking couples to try harder.

One husband said he wished his wife “would just write on her hand, ‘I like sex,’ so she could remember it for the next time,’ ” she recalled with a laugh.

If the act-like-you’re-in-the-mood-first approach doesn’t work, Mrs. Weiner Davis said she recommends other solutions: Some couples may need sexual-skills sessions, especially if they are still using newlywed techniques on aging bodies. Others may need serious therapy to address underlying psychological issues related to rape or abuse, and some may require medical help to address physical issues like pain during sex or libido-suppressing side effects of medicines.

The bottom line, though, is that there are already many ways to treat sexual issues, said Mrs. Weiner Davis, and popping a pill wouldn’t be her first choice.

In Kim’s case, she turned to Dr. Goldstein to address her HSDD, which stemmed from early menopause. Dr. Goldstein helped her regain her sexual health - although it didn’t happen fast enough to save her marriage. HSDD contributed “more than 50 percent” to her recent divorce, Kim said.

She says she would have jumped at the chance to try a daily dose of flibanser, had it been around.

“I’d have taken it, without a doubt,” she said. “Overall, your sexual health is part of your health.”

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