Dr. Kingsberg noted that the disorders have been included in the Diagnostic and Statistical Manual “legitimately for over 30 years, and I’ve been treating hundreds of women.”
DSM-V combined the former DSM-IV diagnoses of hypoactive sexual desire disorder and female sexual arousal disorder into a single sexual dysfunction category, sexual interest/arousal disorder in women.
“The problem is, that it’s not a one-size-fits-all, and that for many women, while there are psychological causes, for another group of women, and a significant group, there are pharmacologic or biologic underlying causes, for which no amount of psychotherapy is going to fix,” Dr. Kingsberg said.
“Having something that will add to my treatment armamentarium and treatment for the generalists out there is tremendously hopeful. Women have been pleading for research to go on, and sort of at least meet halfway some of the research that has been compelling men to get treatment. This has been tremendously exciting, and the women in my practice are going to be very, very happy that research is moving forward.”
Indeed that research should go forward. Besides coming up with new drugs, one key question that needs addressing is, What percentage of women experience FSD? Speaking last year with WBUR radio in Boston, Jan Leslie Shifren, M.D., director of the Menopause Program at Massachusetts General Hospital, said the percentage of women who experience such difficulties hovers around 12%—enough of a gap from 43% to warrant more scrutiny.
Also deserving more scrutiny is the question raised, but not answered, by Dr. Kingsberg: How much psychology and physiology play into FSD—when do symptoms warrant medication, and when might patients be better served by behavioral solutions to struggling with arousal or orgasm?
Do you think future FSD drugs have the potential to be as successful as ED drugs have been?