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 Lack of interest in sex — or lack of desire — is
the most common sexual problem in women, reports the American
College of Obstetricians and Gynecologists (ACOG). As women
approach menopause, they may lose desire slowly, have a hard
time getting aroused and feel pain during sex. The lack of
estrogen that occurs after menopause may make the vagina dry
and cause atrophy. Urogenital atrophy is the most common cause
of arousal disorders in postmenopausal women, and estrogen
replacement is usually the therapy of choice.
Women are often reluctant to discuss issues such as vaginal
dryness and other problems related to sexuality, reports Veronica
Ravnikar, M.D., Chair of the Department of Obstetrics and
Gynecology at Saint Barnabas Medical Center. She urges female
patients with such issues to make an appointment with their
ob/gyns and to be proactive about their health care needs.
"Female sexual function is a very important issue in
the care of all women," says Dr. Ravnikar, M.D. "As
a Department, we hope to further the education of the public
and to launch and support studies for the treatment of sexual
disorders."
Dr. Ravnikar serves on the Greater New York/New Jersey Female
Sexual Function Board, which was established to improve the
standard of care of postmenopausal women with Hypoactive Sexual
Desire Disorder (HSDD) through outreach programs and patient
education.
Menopausal women who are experiencing a lack of desire may
now have a new avenue for treatment. The Food and Drug Administration
has granted preliminary review for what could be the first
prescription treatment from female sexual desire disorder
in menopausal women. The medication is delivered in the form
of a testosterone patch.
The FDA granted preliminary review to the investigational
female testosterone patch for the treatment of HSDD in menopausal
women. If approved, the patch will be called Intrinsa (testosterone
transdermal system). Data from two Phase III clinical trials
for the patch was presented at the Annual Clinical Meeting
of ACOG in May 2004.
HSDD is defined as a lack of sexual desire and is one of
the most prevalent female sexual health problems. HSDD can
lead to feelings of unhappiness, concern and frustration,
and negatively impact a woman's relationship with her partner.
According to a recent study, one in three menopausal women
in the U.S. has low sexual desire and nearly half of these
women report being concerned about it.
If a women is experiencing a decrease is sexual desire or
function, she should discuss her concerns with her obstetrician-gynecologist,
says Dr. Ravnikar. She adds that the problem is more common
than most women think.
"We literally hear women say that they love their husbands,
but that they have no sexual desire," relates Dr. Ravnikar. "This
situation can occur out of no where, sometimes from a lack
of testosterone. Women in this situation can rely on the expertise
of their obstetrician-gynecologist and should understand that
there are different avenues for care."
The Cornelia Center for Advanced Sexual Therapeutics in
Livingston has been established for the treatment of sexual
dysfunction and related conditions. The physician team includes
Regina Kaplan, M.D., and Tina Petillo, D.O., attending ob/gyns;
and Joseph Ditrolio, M.D., attending urologist; each of whom
is affiliated with Saint Barnabas Medical Center. Specialists
are available from fields that include gynecology, urology,
osteopathy, psychology, sex therapy, massage and nutrition.
Among other conditions, the Cornelia Center treats arousal
disorder, anorgasmia, vulvodynia, low sexual desire, vaginismus
and erectile dysfunction.
"Sexual dysfunction is a medical problem that should
be taken seriously, and women can look forward to new treatments
on the horizon," says Dr. Ravnikar.
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