Women’s sexuality is often described as “complicated,” a word that tends to suggest something “difficult” or “best not discussed.” But women’s sexuality literally is complicated, in the purest definition of the word: from the acrobatics it takes to undo our bras to the mysterious forces that seem to stoke or decimate our desire. And that is why, doctors will tell you, coming up with a solution for female sexual dysfunction is more difficult than it is for, say, erectile dysfunction.
Even the terminology is complicated. While erectile dysfunction isn’t hard (pardon the pun) to understand, what is female sexual dysfunction anyway? According to the benchmarks of the female sexual function index (FSFI), one of the standard tests that researchers rely on, the condition occurs when one or all of the following factors get out of whack: desire, arousal, lubrication, orgasm, satisfaction, and pain (often due to the aftershocks of vaginal delivery).
“The fact is, women’s and men’s sexuality are very different,” says Shieva Ghofrany, M.D., an obstetrician-gynecologist in Stamford, Connecticut. “Men are able to procreate into their 90s, and our bodies don’t even give us the option after about 50, which is one of the reasons our desire decreases. If men were in this position, I truly believe this problem would be solved.” However, simply wishing for a female Viagra does women a disservice. A product that worked purely via clitoral stimulation (basically an analogue to Viagra) might help with arousal, but that doesn’t address the real problem. “It’s getting there that’s the problem for so many of my patients,” Ghofrany says.
“If men were in this position, I truly believe this problem would be solved.”
And that’s where DHEA, a hormone produced naturally in the adrenal gland, comes in. Fifteen years ago, Norbert Gleicher, M.D., medical director and chief scientist at New York’s Center for Human Reproduction (CHR), discovered that DHEA could help women get pregnant by raising male hormone levels, particularly testosterone. “Until then, doctors thought testosterone was a terrible thing to give to women with fertility issues when, in fact, the opposite turned out to be true,” he says. But a funny thing happened on the way to conception. Gleicher says that after getting pregnant, many of his patients who were supplementing with DHEA didn’t want to stop taking it, reporting that it made them more excited to have sex.
So Gleicher conducted a study. A group of 87 infertility patients was asked to complete an FSFI questionnaire prior to supplementing with 25 milligrams of oral micronized DHEA three times a day, and then again four to eight weeks later. Interestingly, 40 percent of women with low initial sexual satisfaction reported an increase in desire, 46 percent in arousal, 33 percent in lubrication, 54 percent in orgasm, and 24 percent in satisfaction, while 25 percent said sex was less painful.
There are drugs for female sexual dysfunction, but there’s risk: The newly FDA- approved Vyleesi, an injectable medication, is said to boost sex drive, although “40 percent of users develop nausea for up to two hours,” says Gleicher. Addyi was touted as the female Viagra when it debuted in 2015, but it comes with a black box warning—the strictest alert the FDA puts on the labeling of drugs—due to its incompatibility with alcohol and certain medications (to quote Stephen Colbert, “Nothing gets you in the mood like staring at your longtime partner stone-cold sober”).
As an alternative to these, CHR, in collaboration with Fertility Nutraceuticals, developed VIVO. Like the supplement used in the study, VIVO contains 25 milligrams of DHEA and must be taken three times a day. (Gleicher says that unlike some other DHEA supplements that you can buy at a health food store, the DHEA in VIVO is standardized, so it’s properly micronized and at its fullest potency.) It’s available without a prescription; a six-week supply will set you back just over $100.
Ghofrany thinks that compliance and price may be problematic for the average woman, but Angela Williams* is sold. Williams, who was part of the study, says, “When I was in the study, whether I was tired or working all day, I still felt like I wanted it when I came home.” Williams has since had a second child. She says she has often thought about going on the supplement again. “But now I really need the sleep more.”
*Name has been changed
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This article originally appears in the September 2019 print issue of Harper’s Bazaar, available on newsstands August 20.
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