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Sex Drive Need a Tune-Up?

Question

What is female sexual dysfunction? Is it a medical term for low sex drive? If so, what can be done about it?

-- Stephanie

Answer

You ask a provocative question. This past January an article in the British Medical Journal claimed that pharmaceutical companies are trying to create a condition called “female sexual dysfunction” that may not exist, even though some estimates are that 43 percent of women suffer from it. One source for that figure was an article in the Journal of the American Medical Association in 1999. It reported on responses from 1,500 women to questions on whether they had experienced sex-related problems such as lack of desire or lack of lubrication for at least two months. However, the authors have said that some of those sexual problems were related to such issues as a drop in income, having young children at home or other sources of stress and didn’t reflect a “medical” problem requiring treatment.

On the issue of low sex drive, a study from the University of Pennsylvania published last October found that women who reported declining libido had fluctuating levels of testosterone, the hormone that governs sex drive in both men and women. Those who had the most variability in testosterone levels were two to three times more likely to report decreased libido than those who had the most stable testosterone levels. In the past, researchers believed that decreased levels of testosterone, particularly after menopause, were to blame for declining sex drive among women. Apart from the fluctuations in testosterone levels, the only other factors affecting the female sex drive discovered in this study were depression and having children in the house.

Women’s bodies produce about one-seventh the amount of testosterone daily that men do. About half the female supply comes from the ovaries and half from the adrenal glands. If a woman’s ovaries are removed, she’ll lose half her testosterone supply and may notice a decline in her sex drive as a result. After menopause, women’s testosterone levels drop about one-third. Testosterone replacement is an option, but the best method of administering it – a skin patch, which delivers the hormone so that it can be evenly absorbed – isn’t yet available for women. In the meantime, you might ask your gynecologist about another option, Estratest, a prescription drug combining estrogen and testosterone.

By Andrew Weil, M.D.