Stop Suffering in Silence: A Step-by-Step Guide to Talking to Your Doctor About HSDD and Low Desire

When we misplace our keys or reading glasses, we joke about it with our family and social circle. But when we lose something else—our sexual desire—we get real quiet. These days, there’s no reason to suffer in silence. If this important part of your life has gone missing, speak up at your next doctor’s appointment. Loss of libido can be caused by real biological changes. And there are easy fixes available—including a once-daily, FDA-approved, non-hormonal pill—that can help you feel that natural spark again. To make the process easy and painless, we’ve gathered expert advice on how exactly to broach the subject with a health care provider. Here’s how to talk to your doctor about disappearing desire.

Why your doctor should ask about your sex drive (but probably won’t)

In a perfect world, your doctor would broach the subject of libido for you. “Doing a sexual health assessment and asking a woman about her sex drive should be commonplace in a primary care physician’s office,” says Beverly Young, MD, a psychiatrist and cofounder of BRIA Academy, who specializes in sexual health. “However, many clinicians still feel uncomfortable or do not think it’s relevant to ask about sexual health.” In fact, many doctors never ask patients about their sex life beyond the reproductive years.

“I don’t think the onus should be on women,” stresses Dr. Young. “Like most medical issues, I think it should be the doctor who actually brings up the conversation.” That should be the case with clinically low sexual desire, a condition called hypoactive sexual desire disorder (HSDD). But many of those conversations aren’t happening, which is unfortunate since approximately one in three women experience distressing low sexual desire. That’s why it’s up to you to start the dialogue—and here’s exactly how to do it.

Did you know that low mojo feeling has a name and a fix? Head to our Desire Hub for real answers.

How to talk to your doctor about low desire

Follow this step-by-step guide…

Step 1: Find a doctor who understands women’s sexual health

Not all doctors are educated about women’s desire. Almost nothing is taught in medical school about women’s sexual health beyond pregnancy and reproductive cancers. Things are changing and improving, but “not all doctors are well-informed,” says sex educator Carol Queen, PhD. “If your doc minimizes your sexual experience, please try to find someone else to address this part of your health.”

In the documentary The Pink Pill, about the introduction of the first FDA-approved medication, Addyi, to treat women’s low desire, Rachel Rubin, MD, shared, “You learn absolutely nothing in medical school about sexual medicine at all for anybody.” The urologist and sex-med specialist, who has been called “the sex detective,” adds, “In fact, in the ob-gyn residency, the word clitoris doesn’t appear anywhere in what they have to learn.”

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Step 2: Try these conversation starters

When the spark is gone and you want it back, here’s how to ignite an easy conversation with your health-care provider:

Try using these exact words when bringing up low libido. “Do you have any suggestions on how I can increase my sex drive?’” suggests Dr. Young. “Sometimes it’s easier for people to think of this as just another medical illness and ask, ‘Is there something wrong with me medically?’”

Queen agrees that starting this health conversation should feel comfortable, not intimidating. She suggests, “An easy way to begin: Just say something like ‘I wonder if I have low desire?’ or ‘I wonder if there’s a reason that I have a hard time reaching orgasm?’” Queen adds, “You can add that things have changed regarding your desire, or that you’ve learned that midlife is a time when this is fairly common.”

“Include anything that puts your personal situation into a larger context of health,” explains Queen. “Opening up about it begins the process of learning about these changes and their relevance to you.”

Want more ideas? Download our free conversation guide with ready-to-use scripts for reference.

Step 3: Ask to be evaluated for HSDD

Doctors will want to know how long your low desire has persisted. The condition involves issues that have lasted longer than six months. Also share how low desire has impacted your life. Has it caused any distress in your personal life, your confidence or your relationship? Lastly, doctors will want to rule out whether anything else—such as low thyroid function or a prescription drug interaction—may be causing your low desire.

Step 4: Ask your doctor if FDA-approved medication can help

A generation ago, women suffered in silence because there were no drugs approved for them for low sexual desire. But things are changing. When talking to your doctor, another good question to ask is whether the daily pill Addyi, approved to treat both pre and postmenopausal women under 65 with HSDD, might help you. It gently works to rebalance brain chemicals linked to desire.

“Addyi is giving clinicians an evidence-based, structured approach to treating what may be a very stressful and difficult-to-treat condition,” says Louis Lerebours, MD, a family medicine physician at Freeman Recovery Center. “I have faith in this drug because of the clinical trials that were completed on it. There was safety monitoring established and all patients are assessed using a complete biopsychosocial evaluation.”

Another option: Vyleesi (bremelanotide), an on-demand injectable medication FDA-approved for premenopausal women with HSDD. The shot is taken in the belly or thigh at least 45 minutes before sexual activity to help boost libido. It can be taken up to eight times per month, but it comes with a 40 percent chance of nausea. “It has side effects that preclude a lot of people from really enjoying it, but it is on demand” so it is convenient, explains Sameena Rahman, MD, a sex-med gynecologist and founder of GYN & Sexual Medicine Collective. “I call it like a date night drug or the drug that you would use on a weekend getaway.”

More ways to take charge of your sexual health

Keep educating yourself

As the saying goes, you don’t know what you don’t know. “If all you’ve ever heard is that sex is supposed to be painful or midlife means the end of your desire, all of that culminates into people not expecting that they can do any better,” explains Dr. Rahman.

Stay informed to help future conversations about desire. “Engage in as much learning—reading, seeking out trustworthy online sources—as you can,” suggests Queen. “When someone doesn’t know a lot about sexuality in the first place—most of us got pretty poor sex ed and many of us were raised in conservative contexts that can foster sexual shame—it is easy to listen to anyone and think of them as credible.”

Try telehealth services

Consult with doctors and health experts who stay current on the latest research regarding women’s desire and an FDA-approved treatment. Need help finding knowledgeable, up-to-date doctors? This telehealth service can help you get a diagnosis in the comfort of your own home.

Consider bringing your partner into the conversation

HSDD is defined as a lack of sex drive that is causing distress in your life or your relationship. So consider bringing your partner to a medical appointment or including them in a telehealth call to help educate them. “I love it when someone brings their significant other with them, because part of understanding this is understanding how our desire works,” Dr. Rahman says. She adds that HSDD is a biopsychosocial condition—meaning it has biological, psychological and social components—“and we have so many more treatment options now like Addyi and sex therapy.”

Bottom line on talking to a doctor about HSDD

Start the conversation and treat it like any other health concern—because it is one. A simple question like “Do you have any suggestions for increasing my sex drive?” can open the door to real solutions. Rest assured, there’s nothing wrong with you, but there could be a biological shift—with your brain chemicals, for example—dampening your sex drive. Help is available and you deserve to restore this lost and precious part of your life.