The first question I think is a straightforward what is female sexual dysfunction? Female sexual dysfunction from a medical perspective is referring to problems of sex related to the desire or drive for sex; problems with arousal; concerns with orgasm either not having one or being difficult to have an orgasm; problems with pain with sex.
Should our expectations for sex in our sex lives change as we age? I think as women age, they may experience changes in their sexual function but in general, if they have been enjoying sex throughout their lifetime, they should continue to expect that they would enjoy as they age.
So if something has changed for a woman with regard to her sex life and she says: “Ahh, I’m just getting older and have the menopause. It’s just going to go away.” In your view, that’s not an explanation, yes? Women tend to blame themselves often for a sexual problem, and so often they may not seek help because they assume it’s their fault, or there is not treatment for it, when, in fact, often that are their physiological or medical conditions that bring on a sexual function change, and then they end up having relationship or emotional health consequences. And so it is very important to address all of those things.
So it can be quite a chicken-and-egg question, what came first. You know there are some people who don’t even believe that female sexual dysfunction is a real disease, they say:”It’s a disease that is made up by the drug companies, they want to sell medications, to treat this, but it’s not really a diagnosis that can be made.” What do you think of that? I certainly think as from a medical perspective, if you have changes in a woman’s sexual desire, you have to visit a doctor in order to discuss it, and diagnose it, and treat it, and bill for it. Yes, there are icd-9 codes that we use, and yes, we have to make a diagnosis. In terms of specific medical treatment that is something, that’s controversial. However, I think there is a place for using particularly estrogen and testosterone in women, who have sexual concerns.