Why the “little pink pill” may not be a cure-all for female sex drive

couple_fighting_640In June, Food and Drug Administration (FDA) panelists recommended the approval of Flibanserin, also known as the new female Viagra. Flibanserin is a little pink pill meant to treat low sex drive in women by targeting the dopamine and serotonin chemicals in the brain. As with any new drug, numerous studies have been conducted to ensure we know as much as possible about it and its side effects before it becomes available to the public. Flibanserin makes a lot of promises for a serious issue that plagues many women in the U.S. — more than one in three, according to a survey published in the Archives of Internal Medicine. But even if it does get approved, it’s not necessarily going to be a cure-all for low sex drive in women.

As a hormone specialist, I’ve treated many women with low sex drive, have gotten all their hormones perfectly in line, and sex was still not happening. Why? Because female arousal is multi-faceted. Unlike a headache that might be “fixed” with a pill, there are numerous reasons why a woman may not want to have sex — from stress to hormones to the state of her relationship — and Flibanserin isn’t designed to address all of these issues. There’s a framework I use to define low sex drive, and, in a word, it’s HARSH: Habits, Attitude, Relationships, Stress, and Hormones. Let me elaborate…

Your daily habits mean the difference between feeling great and being exhausted, ill, or having no drive. So if you suffer from low sex drive, ask yourself, “What daily habits could be contributing to this state?” A study published in the journal Psychotherapy and Psychosomatics found that people who engage in low-intensity workouts — which can be anything from a brisk walk to yoga — can increase their energy levels by 20 percent. The food you eat also has a critical effect on how you feel, including your energy and mood. Processed and greasy fried foods can slow you down and make feeling sexy nearly impossible. Having a healthier diet can do wonders for your health, energy and even your hormone balance.

How you feel about sex and how you feel about your body has a major effect on whether you feel like having sex. Feelings of guilt, insecurity, or some idea that you should look like a model, for instance, can make you feel like quitting before you even begin. If you don’t feel sexy, you’re not going to feel like having sex. Try making a conscious effort to focus on the things you like about your body instead of the parts you’re not so happy about. It can also be helpful to remember that sex is healthy and natural, and having it is a great way to bond with your partner and release tension and stress.

The top two causes of female sexual dysfunction are the emotional relationship with her partner and her own emotional well-being, as reported in a national survey. I encounter many women who say they’re very happy with their spouse but there’s tension due to “little things.” Your relationship with your partner is one of the biggest factors that can affect your desire to have sex, and too many “little things” can often make you resentful toward him or her. Because most women are nurturers, they often do so much for other people that they rarely stop to take care of themselves. As my very wise therapist once told me, “When self-care is low, resentment is high.” It’s very rewarding to take care of others, but make sure you’re not neglecting yourself and are communicating with your partner when issues, no matter how big or how small, bother you.

When you’re stressed because your boss has added yet another task to your mountain of work, your “fight or flight” response is activated. Fight-or-flight was key to our ancestors’ survival when they were being chased by saber-toothed tigers, but more and more, most of us spend the majority of our days in saber-toothed tiger mode. When you’re suffering from chronic stress due to modern-day stressors like deadlines, traveling or a financial crisis, your body has a hard time switching from stress response to sexual desire. That’s why one of the most important things you can do for your sex drive — and your health — is to take steps to manage stress, whether it’s through exercise or meditation.

Your hormones, of course, play a very powerful role in determining how interested you are in sex. Testosterone, estrogen and progesterone are needed from the first step of desiring your partner, to physical arousal, to the post-sex recovery. Elevated cortisol levels from too much stress or a poor diet can result in lowered amounts of these crucial hormones. Exercise is a great way to naturally increase testosterone, but in this study done on female athletes, women with higher levels of cortisol saw less of an increase in testosterone than women with lower levels of cortisol. Taking steps to improve hormone balance — through diet, exercise, managing stress, and in some cases taking supplements or even hormones — is key to getting your sex drive back on track.

Even if Flibanserin were to work for every woman who tried it, it operates as a temporary fix for a multi-layered problem. To truly get your sexuality back on track, look at these five areas within your own life, and address each one for a long-term solution (and trust me, you’ll like the side effects).

This article originally appeared on Fox News, where I’m a regular contributor.

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