I’m just not feeling it!

Just about every day in clinical practice, I encounter a patient who tells me that she’s “just not feeling it”. What is IT referring to?

When more details are shared, there are usually long standing patterns of avoidant sexual behavior.  The woman describes her relationship as being wonderful in almost every way- that she can talk about anything with her partner, except for that pink elephant in the bedroom who has been sleeping between them for way too long.  

Women like this have been suffering in silence, and carry a heavy burden of guilt and shame.  They assume that they are alone, and that their girlfriends are having lots of great sex!  They picture the girls of “Sex and the City” and fall prey to the media’s portrayal of sex being the equivalent to breathing.  “If you’re not having sex, there must be wrong with you.” says her  inner voice so loudly she’s sure everyone know’s how damaged she is.

The feelings may be so deeply rooted in diminished self worth that the topic of sex is altogether avoided. Few women may confide in their friends, or their partner, that they have little to zero desire for sex, that they don’t think about having sex, don’t feel turned on, struggle emotionally when it comes to engaging in sexual activity with their partner, and describe sex as being like a chore. In fact, they’d prefer to take out the garbage or wash dishes then let their partner see them undressed, let alone be touched.  The reasons for this avoidance range from having a terrible migraine, to feeling too tired or unattractive.  They say that if their partner would agree,  they would be fine with never having sex again.

But I have never seen a partner consent to this notion. The catalyst that often brings the woman (or the couple) into my office is that the other partner is feeling upset and hurt from having been rejected time after time. Another presenting symptom is that the relationship is so volatile from arguing over sexual issues that they are on the verge of calling it quits. For women presenting with symptoms of acquired Hypoactive (low) Sexual Desire Disorder (HSDD), the question often comes back to “What can I do to fix this?” The answer is generally not a quick fix or as simple as taking a pill. Or is it?

In August 2015, the FDA recognized and approved the first pharmacological medication to treat acquired HSDD in premenopausal women. This drug, scientifically proven to treat HSDD is called flibanserin, or by name brand Addyi. The “pink pill” nicknamed “the female viagra” is an approved medical treatment option for many women who are bothered by their lack of sexual desire.  There are restrictions, for example, women are counseled by their provider that they should not consume ANY alcohol while taking flibanserin, which for many can be a deterrent. If you are contemplating treating HSDD with this medication, you can set up an appointment with a physician who is certified to prescribe it, and find this information in their directory (www.addyi.com).

I recently attended a 4-day-conference through the International Society for the Study of Womens’ Sexual Health (ISSWSH), where health professionals come together to learn about new advances that can improve the lives of their patients and clients.

As a sex therapist, I advocate for my clients and constantly learn more about treatment options that may help increase their quality of life.  I help them to believe and recognize the importance of self care, and that they deserve to have pleasurable and fulfilling sexual relationships. Treatment is not a one-size-fits-all, and Addyi is not necessarily right for everyone. Loss of sexual desire can take a painful toll on a relationship, and if you have reached that pivotal point of weighing your options, there are helpful ways to treat and regain that feeling of desire. Here’s to recognizing that your sexual desire matters!

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