Is Sexual Medicine a Cure for Sexual Ailments?
Just over a week ago, the FDA approved a new drug called Vyleesi™ (bremelanotide injection). It is designed to help women who experience little or no drive or feeling of wanting to have sex. The medication is injected about 45 minutes before sexual activity and creates a sense of sexual desire.
Because the feeling of desire is experienced, it can also help with subsequent sexual arousal. When sex is wanted and feels good, it can become something that the woman looks forward to enjoying again, perhaps creating an incentive to inject Vyleesi™ more.
While some sexologists see this as a misguided manipulation of a woman’s sexuality (e.g., Leonore Tiefer), others see it as just another option in the tool kit for women who miss the feeling of “wanting to want sex” (e.g., Sheryl Kingsberg).
Applying the sexological ecosystem from my own work, there are much broader issues to consider regarding Vyleesi™, Addyi™ (flibanserin), testosterone, or any medical approach to female sexual desire other than seeking a cure.
Who is it, for example, that wants the woman to want to experience sexual desire? Is sexual desire necessary for a woman to participate in sexual activity? Are there other reasons to want sex besides having desire for it, e.g., to feel emotionally close to someone, to have an orgasm, or to help one’s partner have an orgasm? What does it say about attitudes toward aging and sexuality that a woman must continue to feel the same level of sexual desire as she did when she was younger in order to feel normal?
Over the years, I have had many women in my office who have tried “everything” to improve their desire—everything, that is, except what we identify working patiently together for a session or two—or twelve. It is common for women to suffer from depression, but it seems that it’s almost as common for it to go unrecognized, as if looking at life through gauze was a normal state of mind. That will certainly flatline your drive.
Anxiety is also common; many women feel internal and external pressure to do things perfectly, even sex. If they have a partner who is complaining, it creates more pressure—and more anxiety, and therefore less drive. Then there is no end to the number of relationship problems.
One woman who insisted she had a “good” relationship finally admitted that she felt unheard by her partner. She was sad that he listened to and helped others but neglected requests to help her. Yes, she had a responsibility to communicate this to him. But if you’re married to the guy that everyone loves plus have difficulty feeling that you are entitled to feel and express anger, then nothing happens—in or out of the bedroom.
Women’s sexual problems are very common, and it is why LearnSexTherapy.com offers a separate course for these challenges. BTW if you take certain courses with us, then decide later to take the Core Knowledge or Blended Learning Program, we will give you an appropriate discount! It’s a low-risk way to check out how courses are organized and whether you will enjoy learning online.
Just a note; I will be updating specific courses and materials over the summer and fall months. If you have suggestions, I am all ears! I want to ensure that I am inclusive and sensitive to both those enrolled in programs and those whom they will treat. Our world has always been diverse, but if there is a bright side to the Internet, it also has made our world more open.
The best music to my ears as a clinician is when someone tells me that they feel safe in my office because they were fully accepted. I want anyone who takes my courses to come away with understanding and acceptance as well.
When we can sit in non-judgment of our patients or clients, we allow them to discover and give expression to who they truly are. And hopefully, we can help them take the next positive step in their sexual and relational life journey.
Just email me at if you have an article, website, short documentary, etc. that you think would help me make our programs more inclusive and would be interesting to a wide audience of psychotherapists and medical providers such as pelvic floor physical therapists. Thanks.
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