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A clinician’s perspective: What I wish my patients knew about low sexual desire

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WRITTEN BY: Dr. Lisa Larkin

Women’s sexual health is an area of patient care that has been neglected for far too long. As a women’s health internist for over 30 years, that’s something that, unfortunately, I know far too well. I also know that women’s sexual health is not just a “lifestyle” issue; it’s intertwined with our overall health. 

Sexual health problems in women are quite common. In a survey of over 31,000 women, about 40% had experienced a sexual problem.1 When a woman’s sexual problem is severe enough to cause her distress, it may be considered a sexual dysfunction. The most common female sexual dysfunction is hypoactive sexual desire disorder (HSDD), which is defined as ongoing low sexual desire that women find frustrating. In the US, HSDD affects approximately 1 out of every 10 women.2 

HSDD can have a profound impact on a woman’s well-being. It can affect a woman’s self-esteem and body image, and make her feel inadequate, insecure or hopeless. Despite this, surveys show that many US doctors don’t ask their female patients about sexual health concerns on a regular basis.3 And too often, women don’t raise the subject themselves, expecting that their healthcare provider will ask. 

So, if there’s something that I wish that my patients—and all women—knew, it’s that they have a right to sexual healthcare. And that if they’re going to get it, we’re going to have to change that narrative.


…women’s sexual health is not just a ‘lifestyle’ issue; it’s intertwined with our overall health.”


Be your own advocate
I believe that women must be educated about sexual health, know that their sexual health concerns are legitimate, and advocate for their sexual healthcare. 

It’s clear that there are gender discrepancies in sexual healthcare. For example, until just a few years ago, there were numerous medications for men with erectile dysfunction,4 but zero specifically approved for women with frustrating low sexual desire. While doctors apparently have become comfortable using the term “erectile dysfunction” and prescribing treatment for it, too many still aren’t comfortable talking about sexual health issues with their female patients. 

Women’s gender-specific health needs are neglected for many reasons. These may include too little sexual health training in medical school and residency, cultural bias that leads to dismissing women’s health issues and symptoms, lack of inclusion of women in clinical trials, and low awareness of the gender differences in disease presentation and gender specific drug effects. 

What I think this means for women is this: don’t wait for your doctor to ask if you’re having a problem with low sexual desire or any other aspect of your sexual health. Bring the subject up and make it clear that you want to explore solutions. Also, take advantage of educational and support resources, such as those here on unblush. 


… I wish that my patients—and all women—knew that they have a right to sexual healthcare.”


A new era for women’s sexual health
In spite of the challenges, I see a cultural shift occurring in women’s sexual healthcare. 

There’s a growing “femtech” (female technology) movement resulting in more research and development in women’s health. Women’s health startup companies are receiving more venture capital funding than ever before.5 And as of June 2019, we now have two FDA-approved medications for HSDD.

Learn about an FDA-approved treatment for HSDD

The bottom line: as with #MeToo and #TimesUp on other fronts, it’s time to speak up for gender equity in healthcare. As a woman, you should demand high-quality gender-specific care. When it comes to your sexual health, you must advocate for yourself. There are clinicians out there who are trained in sexual medicine. And the good news is now there are FDA-approved medications to help. Be heard and get the care you need and deserve.


The information on this website is for educational purposes only. You should not use the information here for diagnosing a condition. For medical advice, please consult your healthcare professional.

  1. Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol. 2008;112(5):970-978.
  2. Ibid.
  3. Kingsberg, Sheryl A. et al. “Female Sexual Health: Barriers to Optimal Outcomes and a Roadmap for Improved Patient–Clinician Communications.” Journal of women’s health(2019).
  4. “Medications for Erectile Dysfunction.”, Accessed September 6, 2019,
  5. Olsen, D., 2018, This year is setting records for femtech funding,PitchBook, Accessed September 11, 2019,

About the Author
Dr. Lisa Larkin is a board-certified internist practicing internal medicine and women’s health since 1991. She is the Founder and CEO of Ms. Medicine, LLC, a national membership organization for women’s health clinicians and a concierge women’s health primary care network. She is also owner and President of Lisa Larkin, MD, and Associates, an independent, multispecialty practice offering direct primary care (DPC), concierge primary care and women’s healthcare in Cincinnati, Ohio. In addition, she serves as Director of Women’s Corporate Health for TriHealth, and she is the Founder and Executive Director of the Cincinnati Sexual Health Consortium, a non-profit designed to improve the sexual health and wellness of individuals in the Greater Cincinnati region through improved clinician collaboration and community outreach.

Dr. Larkin’s article for unblush is for educational purposes only; it is not meant to be medical advice.

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  • what is hsdd?

    It’s a treatable medical condition also called hypoactive sexual desire disorder. Women with HSDD have decreased sexual desire that they find frustrating. HSDD can lower your self esteem and strain your relationship. If that’s what you’re feeling, don’t feel alone or embarrassed—unblush.

  • Resources

    Medical conversations for HSDD and low female sex drive
    Conversation Starter

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    Symptom Checker

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    How to talk about female libido issues
    Talking to Your Partner

    It’s not easy, but it’s so important. These tips can help you have an open, honest conversation.

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