FSD – Tacit Female Disorder or Imaginary Disease?

12. September 2006

There is hardly any topic in medicine causing such a riot as FSD - female sexual dysfunction. Skeptics leave no stone unturned to prove that this is an imaginary disease. On the other hand there is a cohort of physicians trying to fathom the relations between woman and sexuality.

At the same time, those we are talking about, are somehow ignored: namely the women. And they confirm that they do have sexual needs and desires through to their senior years.

Sexual research strongly concentrated on men over the last years, because things about sex seem to be clear-cut: If the penis does not react accordingly, no sexual intercourse takes place. With women the situation is a whole lot more complex, thus causing scientists to fail time and again, if they focus only on the female genitals. Already Sigmund Freud considered women a “dark continent”. Only recently women brought some light into the dark: Dr. Rosemary Basson of the Vancouver Hospital and Health Sciences Center in British Columbia can be considered a precursor, because she summoned her colleagues. Out came a description of the female sexual activities, which cleared a lot of myths. In 2004 this article was published in the “Journal of Sexual Medicine”, showing, with a scientific approach, that women work differently from men. Basson and her colleagues emphasized that sex for women is made of a complex network including not only arousal and blood flow in the genitals as for men, but also that moods, shame, stress, distraction and other non-sexual factors play an important role.

Is it just about launching new drugs?

All are having difficulties though to exactly define FDS. One of the reasons might be, that four different disorders are hiding behind this generic term. Those sexual problems, know for a long time, are low lust, orgasm problems, pain when having sex and problems with getting aroused at all. Facing the difficulties of a precise definition, opponents agitate and spread the opinion that FDS is an imaginary disease. In 2005 the opinion of Ray Moynihan even was published in the reputed British Medical Journal named “The marketing of a disease: female sexual dysfunction”, declaring that the pharmaceutical industry wanted to talk women into having a new disease. The New Yorker psychotherapist Leonore Tauber assented to this statement and installed an entire Webpage against FSD. “It's just money that's motoring that new disease”, propagandized the self-appointed combatant against FSD.

Nearly every other woman is suffering from a lack of lust

However, even the opponents have to admit that not only men do have sexual problems. Everybody also agrees that the people concerned are bothered by their listlessness. Epidemiological studies are trying to clear, how many women are suffering from female sexual dysfunction. Affected are 43 percent of all American women, calculated Dr. Edward Laumann and colleagues at the University of Chicago, based on a study in 1999. Dr. Kathleen Connell of the Yale School of Medicine discover, that almost 48% of all women suffer from female sexual dysfunction. The 2003 Cologne Community 20,000 Survey in Germany even showed a result of 60%, which means, more than every other woman has a lack of sexual lust for different reasons.

No more sex after the period?

Especially women after their menopause are afflicted with sexual dysfunctions as the Australian physician Lorraine Dennerstein learned in her studies. The reason here seems to be the hormone Testosterone that is also responsible for the female sex drive. If the production fails or is reduced as during the climacteric period, the female sex drive follows the hormone down. This shows especially strong in women with an “artificial” start into the menopause, caused by the surgical removal of their ovaries. A treatment with hormone-containing drugs might help these women.

Do older women want sex at all?

If a woman has an under-average libido, she is likely to not want any treatment. And older women are not interested in sex anyways, as it is heard frequently. But this is definitely not true. It is more likely, that shame is holding women from announcing their opinion as vociferous as the male gender. An article in the Hamburg Abendblatt “Tenderness, love and sex – there is no age limit” provoked plenty of reactions from women. The mutual tenor of the letters of the readers was: Eros and sexus are just as much part of an older woman's life and essential for a really happy relationship. And some of this was written by 80-years old women. The majority of the women were extremely satisfied that this topic was finally being discussed so openly.

Disease or not – women deserve attention

In the end, it is irrelevant whether FSD is an acknowledged disease or not. Fact is that women of any age suffering from sexual dysfunction should get a treatment. And it does not always have to be the “chemical club” as declared by Ulrike Brandenburg, sex therapist. Partner- and communication therapy, according to her, can be at least as successful. And if there was a pill for a better sex drive for women – why – except for medical risks – not take it? Men have PDE-5 inhibitors and women suffer quietly – those days should be over.

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