Treatment Options for HSDD

The treatment of HSDD starts with a visit to a licensed physician to assist with the correct diagnosis and approach to sexual dysfunction and distress. If the physician diagnoses or suspects HSDD, a number of treatment options or combination of options may be discussed with you.

Pharmacologic Therapy

Pharmacological therapy is the use of drugs in the treatment of a condition. Flibanserin (trade name: PRAddyi®)1 is indicated for the treatment of premenopausal women with acquired, generalized hypoactive sexual desire disorder (HSDD), as characterized by low sexual desire for a minimum of 6 months, which occurs 75-100% of the time, that causes marked distress or interpersonal difficulty and is NOT due to1:

● A co-existing medical or psychiatric condition
● Problems within the relationship
● The effects of a medication or other drug substance

The most common side effects of flibanserin occur in about 10-12% of women and include: sleepiness, dizziness, nausea and fatigue. Flibanserin is contraindicated in women who have blood pressure below 110mmHg (systolic) or 60mmHg (distolic) who also consume alcohol; women who are pregnant or breastfeeding; women with hepatic impairment or who are taking drugs known to be moderate or strong CYP3A4 inhibitors. Your doctor will consider all warnings, precautions and contraindications when considering prescribing this product.1

Counseling / Sex Therapy

Through therapy, a number of factors can be addressed, such as issues around intimacy, physical health, and cultural norms, and may include cognitive behavioral therapy.2

Sex therapy is a type of psychotherapy that provides sexual guidance to partners with sexual incompatibilities or sexual dysfunction. Topics that might be addressed include basic anatomy and physiology, what normal sexual response is, and how sexuality changes as a person ages.3

Psychotherapy

Psychotherapy typically focuses on modifying beliefs, behaviours and emotions that interfere with desire. This includes addressing negative thoughts and expectations along with cultural and religious standards. Mindfulness is a type of psychotherapy that encourages participants to connect and engage with their sexuality to enhance self-acceptance and self-compassion.4

References

1. Addyi–Flibanserin product monograph: http://hc-sc.gc.ca/index-eng.php.2. Bradway C, Boullata J. Pharmacologic therapy for female sexual dysfunction.3. Maclaran K and N Panay. Managing low sexual desire in women. Women’s Health 2011;7:571–583. 4. Goldstein I, Kim NN, Clayton AH, et al. Hypoactive sexual desire disorder. International Society for the Study of Women’s Sexual Health (ISSWSH) expert consensus panel review. Mayo Clin Proc. 2017;92(1):114-128