I’ve been reading a lot lately about FSD, or female sexual dysfunction. Is there such at thing? It strikes me as a fictitious “ailment” that is being promulgated to sell pharmaceuticals to unsuspecting women. What are your thoughts?
I share your skepticism. I think that, for the most part, female sexual dysfunction, or FSD, is a fictional disorder. I also think pharmaceutical companies are trying to hit on a female version of Viagra to treat this imaginary disorder so they can make a bundle, just like they did with as the male version.
So much of female sexuality is caught up with the cultural context of a women’s role in society — family obligations, body image and patriarchal views of marriage, etc. For the most part, men aren’t nearly so encumbered. So when one talks about female sexuality, particularly when the notion of a condition or a disorder arises; ya gotta ask yourself, what’s going on here?
I too have been noticing a lot of discussion in the popular culture lately about female sexual dysfunction. My first response is to ask myself, who’s raising the issue and why? Sure some women, like some men, experience difficulties in terms of desire, arousal and orgasm, but what of it? Is it a syndrome? Is it really a dysfunction? I personally don’t think so. The sexual difficulties most people experience can be explained and dealt with in a less dramatic way then with drugs?
And here’s an interesting phenomenon; the repeated appearance of the term female sexual dysfunction in the media lately actually gives the concept legitimacy. I’m certain the pharmaceutical industry is hoping that it will. If they can make the connection in the public mind between what women experience in terms of desire, arousal and orgasm concerns and what men describe as erectile dysfunction, then most of the work is done. In other words, I think the entire effort is a marketing ploy.
I think we can safely say that, in order to determine what female sexual dysfunction might be, one has to clearly understand what a “normal” sexual response is for a woman. This is where we traditionally run into problems. Sex science is notoriously lacking in this endeavor. One thing for certain, although both women and men have a discernable sexual response cycle, a woman’s sexual response is not the same as a man’s. Even though we can’t say with certainty what “normal” is, therapists are famous for turning difficulties into disorders. And once you have a disorder it becomes the basis for developing a drug therapy. So you can see how this becomes a self-fulfilling prophecy.
Currently there’s a real buzz among clinicians concerning the efficacy of Addyi, the so-called “female Viagra”. But most sexologists, myself included, are unimpressed. Basically, the drug in question is an antidepressant. When I heard that, red flags began to fly. Antidepressants are notorious for their adverse side effects, especially in terms of sexual arousal in both men and women. The second problem with the study was the whole notion of desire and distress. Lots of women experience diminished sexual arousal but are not distressed by it. But if there’s no distress, clinically speaking, then it can’t be considered a disorder. You see where I’m going with this, right? If there’s not a “disorder” there’s no need for a pharmaceutical intervention.
According to the research some of the women in the clinical studies leading up to the approval of the drug claimed they were less distressed by their “condition,” Hypoactive Sexual Desire Disorder, than they were at the beginning of the study. According to clinical trials of Addyi held in 2013, only 8% – 13% of the women experienced “much improved” sexual desire and only about 2 more satisfying sexual encounters per month were had. In other words, when behaviors were studied, the actual number of satisfying sexual episodes reported by these less distressed women hardly changed of all. This indicates to me that the antidepressant helped lift the spirits of the distressed women, but did nothing to increase their satisfaction with their sexual outlet.
Twice the FDA rejected Addyi for its severe side effects and marginal ability to produce the effect that it is being marketed for. And despite the fact that the drug is now available, those side effects still exist. Women who take the pill are likely to experience dizziness, nausea, drowsiness, fainting spells, and falling blood pressure. Coupled with alcohol and even hormonal contraceptives the odds of these potential side effects occurring increase. Persons with liver ailments, or taking certain other medicines, such as types of steroids are also at higher risk. On the other hand Viagra has very mild side effects that may include headaches, indigestion, blue-tinted vision and in some cases a stuffy nose.
While a man can pop Viagra an hour or so before he plans to have sex, women who are looking for increased sexual desire need to take Addyi daily for up to a month before they should expect to see any effects.
Why is care for sexual health issues considered a luxury when it’s a necessary part of population health?
By Zachary Hafner
When Americans seek care for most common health conditions, there is rarely much question about coverage. Every day, consumers—including those on Medicaid and Medicare—seek care for sore joints, depression, and even acne without worrying about whether or not their insurance will cover their doctor visits and medications. For the most part, coverage for sexual health issues is less straightforward—but why? Is it because sexual health issues are not considered legitimate illnesses? Because the costs are significant? Or is it because raising the topic of sexual health can offend certain personal and organizational values? Whatever the reason, it is time for a change.
It’s hard to deny the human and economic burden of sexually transmitted infections (STIs) on this country. The CDC estimates that 110 million Americans are infected with an STI, resulting in direct medical costs of $16 billion annually. The most common and fastest growing STI in this country is human papillomavirus (HPV), and it is estimated that half of sexually active men and women will get HPV at some point in their lives. In 2006, a vaccine for HPV was introduced and now there are several. CDC guidelines recommend administering a multi-dose series, costing about $250–450, to all boys and girls at age 11 or 12. (Some states require the vaccine for school admission.) It was included in mandatory coverage under the ACA. Since the HPV vaccine was first recommended in 2006 there has been a 64% reduction in vaccine-type HPV infections among teen girls in the United States.
It seems clear that this kind of care for sexual health is necessary for public health and is also part of caring for the whole individual, a central tenet of population health. But what about sexual health care that doesn’t involve infectious disease? Is it still a population health issue if there’s no communicable disease involved?
Let’s take erectile dysfunction (ED) for example. It is nearly as common in men over 40 as HPV is in the general population—more than half of men over 40 experience some level of ED, and more than 23 million American men have been prescribed Viagra. With a significant portion of the population suffering from ED, is it important for payers and providers to consider ED treatment to be essential health care and to cover it accordingly? Medications like Viagra and Cialis are an expensive burden at upwards of $50 per pill. Medicare D does not cover any drugs for ED, but some private insurers do when the medications are deemed medically necessary by a doctor. A handful of states require them to do so, but they are typically listed as Tier 3 medications—nonessential and with the highest co-pays.
Almost 7 million American women have used infertility services. Coverage for infertility diagnosis and treatment is not mandated by the ACA, though 15 states require commercial payers to provide various levels of coverage. The cost of infertility treatments is highly variable depending on the methods used but in vitro fertilization treatments, as one measure, average upward of $12,000 per attempt.
Are treatments for ED and infertility elective or necessary? In an age of consumerism and heightened attention to the whole patient across a broader continuum of care, organizations that support the availability of a broad set of sexual health services to a diverse group of consumers will have a big competitive advantage, but they may face challenges balancing the costs. Health care has advanced in both technical and philosophical ways that allow people to manage their diseases, cure their problems, and overcome limitations. It has also shone light on the significant advantages to considering a diagnosis in the context of the whole individual—their social and emotional health as well as coexisting conditions. Studies have shown, for example, that infertility, ED, and STIs all have a significant relationship with depression and anxiety.
It’s time sexual health was folded in to the broader definition of wellness instead of marginalized as a separate issue. For too many Americans, it’s too big an issue not to address.
Complete Article HERE!
Dr Sherry Ross says there has long been a gender bias in the way women’s sexual dysfunction has been treated compared to men’s
By Olivia Blair
Despite modern society being able to openly discuss female sexuality, there remains a number of existing taboos.
One of the most glaring is female orgasms. Women are rarely taught about the intricate details of their anatomy and often work these things out through their own experimenting.
What is the best way to get an orgasm? How often should I have one? Should I be able to have one during penetrative intercourse? Why have I never had one? – questions not uncommon to hear among small friendship groups of women over a bottle of wine.
Dr Sherry A Ross, an LA-based gynaecologist with 25 years experience aims to educate with a complete guide to the vagina in her new book She-ology: The Definitive Guide to Women’s Intimate Health. Period.
In the foreword of her book, Dr Sherry notes that “talking about the mighty V outside of doctor’s offices and bedrooms has remained a major taboo” and devoted an entire chapter to the female orgasm. The Independent asked the gynaecologist and obstetrician all the questions about female orgasms that are rarely spoken about.
Why might some women never orgasm?
Attitudes regarding sex, sexuality and gender vary greatly between different cultures and religions. Certain sexual practices, traditions and taboos are passed down through generations, leaving little to the cause of female pleasure or imagination.
For some women, finding and/or enjoying sexual intimacy and sex is difficult, if not impossible. Research suggests that 43% of women report some degree of difficulty and 12% attribute their sexual difficulties to personal distress. Unfortunately, sexual problems worsen with age, peaking in women 45 to 64. For many of these women the problems of sexual dysfunction are treatable, which is why it is so important for women to share their feelings and concerns with a health care provider.
Unfortunately, there has been a history of “gender injustice” in the bedroom. Women have long been ignored when it comes to finding solutions to sexual dysfunction. In short, there are twenty-six approved medications for male erectile dysfunction and zero for women. Clearly, little attention has been paid to the sexual concerns of women, other than those concerns that involve procreation.
How many women might never orgasm?
During my 25 years in private practice, I’ve met a number of women in their 30s, 40s and 50s who have never even had an orgasm. In fact, 10 to 20% of all women have never experienced one.
Issues related to sex are not talked about enough even with a health care provider. Let’s just start by saying, 65 per cent of women are embarrassed to say the word vagina and 45 per cent of women never talk about their vagina with anyone, not even with their doctor.
Some patients say they have pain with sex, have problems with lubrication, don’t have a sex drive or don’t enjoy sex. My first question is “Are you having problems in your relationship?”, “Do you like you partner?” , “Are you able to have an orgasm?”, “ Do you masturbate?” These open-ended questions tend to bring out sexual dysfunction including the inability to have an orgasm.
There is a great deal of embarrassment and shame when a woman admits she has never experienced an orgasm.
Is the inability to not orgasm normal?
The inability not to have had an orgasm can reflect women’s inability to know they own anatomy and may not be a disorder at all. In a survey of women aged 16-25, half could not find the vagina on a medical diagram. A test group of university- aged women didn’t fare much better with one third being unable to find the clitoris on a diagram. Clearly, if you can’t find it, how are you going to seek enjoyment from it?
Women must first understand what brings them pleasure and in their pursuit of happiness they have to understand where their clitoris is and how to stimulate it. Masturbation is a skill. It has to be learned, just as walking, running, singing and brushing your teeth.
What is an orgasm disorder and how would you categorise one?
The inability to have an orgasm falls under the category of Female Sexual Dysfunction of which there are five main problems: low libido or hypoactive sexual desire disorder, painful sex, sexual arousal disorder, an aversion to sex and the inability to orgasm.
Hypoactive sexual disorder, the most common female sexual dysfunction, is characterised by a complete absence of sexual desire. For the 16 million women who suffer from this, the factors involved may vary since sexual desire in women is much more complicated than it is for men. Unlike men, women’s sexual desire, excitement and energy tend to begin in that great organ above the shoulders, rather than the one below the waist. The daily stresses of work, money, children, relationships and diminished energy are common issues contributing to low libido in women. Other causes may be depression, anxiety, lack of privacy, medication side effects, medical conditions such as endometriosis or arthritis, menopausal symptoms or a history of physical or sexual abuse.
You are the person in charge of your vagina and clitoris. First and foremost, get to know your female parts intimately. Understanding your sexual response is a necessary health and wellness skill. Make mastery of that skill a priority.
Complete Article HERE!