It appears that I am not the only one who has legitimate concerns about the effectiveness and safety of Flibanserin.
Flibanserin Flops
June 18th, 2010
The Correlation between Antidepressants and Sexual Desire
June 14th, 2010(This is an article I wrote for Dr. Peter Breggin’s newsletter. He is a prominent psychiatrist, author, and talk show host. Dr. Breggin’s web site)
The disquieting correlation between antidepressant use and loss of sexual desire in females is poorly understood. It is important to delineate the pathways and mechanisms from antidepressant use to loss of sexual desire if we hope to find a solution the condition that has become known as hypoactive sexual desire disorder (HSDD).
HSDD in females is most pronounced with antidepressants that work through increasing levels of a neurotransmitter called serotonin. These drugs, known as SSRI’s are by far the most widely prescribed antidepressants, and include drugs such as; Prozac, Zoloft, Celexa, and Effexor. Not all antidepressants decrease sexual desire. Welbutrin works through a different neurotransmitter, norepinephrine, and it is thought to marginally increase sexual desire in women. A new drug, flibanserin, works by increasing levels of dopamine in the brain. It was first tested as an antidepressant, but failed initial evaluations. It is currently being evaluated by the FDA for use as a stimulant of sexual desire in females.
Given the correlation between SSRI’s and HSDD, it would be natural to assume that the drugs directly decrease libido by interacting on the portion of the brain that controls sexual desire. If this were true, stopping the SSRI should lead to rapid return of sexual desire. The troubling fact that stopping SSRI medication will often not lead to the return of sexual desire brings into question the direct action of the drug on sexual desire. Perhaps the correlation is through another mechanism.
Loss of female sexual desire also strongly correlates with depression. Of course women who are depressed frequently take SSRI’s. One might deduce that if SSRI’s were effective in treating depression, sexual desire would increase. We now know that SSRI’s are no better than placebo drugs in relieving the symptoms of depression. This fact leaves us with the possibility that the loss of sexual desire in females is due in part to inadequately treated depression.
Difficulties in a relationship are frequently the basis of female depression in addition to loss of her sexual desire. When an SSRI drug is used, it will not only inadequately treat her depression, but will hinder her ability and willingness to do the difficult mental work that is necessary to repair that relationship. If this is the root of the correlation between loss of sexual desire and SSRI medication, it becomes apparent that SSRI’s have no place in the treatment of depression with a concurrent loss of sexual desire.
Loss of female sexual desire is in most cases a symptom of a troubled relationship. Women on SSRI antidepressants who suffer from depression and loss of sexual desire should consider carefully discontinuing their medication, while simultaneously enrolling in relationship therapy. This course of action will give her the highest chance of both relieving her depression and restoring her sexual desire. Drugs that are purported to stimulate sexual desire in women will at best mask the underlying cause of the problem, making them a problematic solution to the problem of HSDD.
Dr. Shaw is a practicing Obstetrician and Gynecologist who has developed a program with insights and treatment options for couples who suffer from loss of female sexual desire and male sexual satisfaction. http://fhsdd.com/
Relationships are Two People
June 8th, 2010I thought relationships were the responsibility of two people. Is it possible that one person in a relationship can be entirely responsible for the destruction of the relationship while the other is completely blameless and innocent? Apparently being oblivious to clues of unhappiness and lack of sexual fulfillment in your partner are signs of victimhood. Let’s get real here; relationships break up for reasons, and a significant partner in the relationship is also responsible, the female.
When men abandon a relationship in a sinister or sneaky manner, it is because they have lost sexual fulfillment from the relationship. More often than not, they have found sexual fulfillment elsewhere. They create other excuses for their abandonment of the relationship because they don’t want to believe, or have their ex believe, that they are so shallow as to allow sexual gratification to be the basis of their happiness. The truth however is evident from the myriad of case studies involving men leaving otherwise functional relationships in search of sexual fulfillment.
How important is sexual fulfillment to men? The cost to men of leaving an established and otherwise functional relationship is astronomical. The cost in dollars of divorce will lower his standard of living and take many years for him to recover. He also will damage or completely lose relationships with his children, friends, and members from her family. His reputation will be injured, and he will become the source of gossip and scorn. He will give up a comfortable lifestyle for one of uncertainty and uneasiness. All of this is done for a chance at regaining sexual fulfillment.
She believes that he is happy with her when he gives her all that she desires; a beautiful home, children, security, and the façade of a loving relationship. He does this not to reward her for giving him happiness, but in hopes that she will exchange fulfillment of her desires for fulfillment of his sexual desires. It is this misunderstanding that leads her to believe that he is satisfied with the relationship. Perhaps her false security in the relationship lets her believe that it is all right if she puts less effort into the sexual part of the relationship, when indeed, substantially more effort is required.
We can blame her for taking too much in the home life relationship while abandoning the sexual life relationship. That is not to imply she won’t have sex; she just won’t take a comparable interest in his sexual desires that he takes in her home life desires. She won’t seek to truly satisfy him in the sexual life relationship. Satisfying the male’s sexual desire is not just having sex with him; she has to be a sexual being to him, not just a body who allows him to have sex. If there are any questions what he is really looking for, gather hints from his knew lover. Very likely the ex put less effort than the new lover does where it really counts for him: in the bedroom.
I don’t hold him blameless. He needs to learn how to avoid thinking of her as his mother. He has to convince her that a satisfying sexual relationship is crucial to the survival of their relationship, even if it means denying her happiness in the home life relationship to get his point across. He has to realize that his sexual desires will never be completely filled by any sexual relationship; and learn how to find fulfillment through love and self denial.
Compassion should be shown for both members of a relationship when it ends. Placing blame on one side or the other is not fair or likely to provide learning lessons about the real reasons relationships fail. When one side is empowered to believe that they were faultless in a breakup, they will be doomed to make the same mistakes in subsequent relationships. Much introspection and analysis will reveal the unconscious feelings that contributed to his unhappiness, and her denial of the problems in the relationship. It is easy to place all of the blame on the male who flees a relationship in order to obtain sexual fulfillment. It takes a more objective stance to realize that relationships are between two people, and both of them are responsible for providing for each other’s happiness.
The Male Solution; Nuke the Well
May 31st, 2010A male problem requires a male solution. The oil spill in the Gulf of Mexico is the fault of males. Blindly probing mother earth with a four mile long phallus, with no plan of what to do when the condom breaks, is consummate male behavior. The colossal oily mess is reminiscent of the consequences when boy meets mud puddle. Besides, the whole motivation for unlimited oil; cars, planes, speed, black smoke, and squealing tires, are all male desires. If we just used oil for plastics such as Tupperware, land based oil wells would be able to supply the world with all the oil it needs.
There are differences between female and male solutions to problems. Females are cautious. They want to know the precise chance that their solution will be effective and all the possible consequences to their actions. Their deliberate movement towards a solution takes an inordinate amount of time, and has a lower chance of success, but a higher chance of not making the situation worse. The fallacy in this type of problem solving is that we will never be able to know the real chance of success or all of the consequences of our actions. We are not intelligent enough.
Take for example the “Top Kill” solution of flooding the well with mud and debris. We were told by the “experts” that there was a 60-70% chance that Top Kill would work. This sort of statement is meaningless. Top Kill will work or it won’t; it will be 100% or 0%. If it were truly 60-70%, one would only have to repeat the method several times until we were fortunate, like flipping a coin until you get a heads. If we were to try Top Kill five times, the chance of success would be well over 99%, if the real rate of success was 65%. Top Kill failed, and the real chance of it working was 0%. What the experts where really saying was, “we think there is a 100% chance this will work, and we are right about something like this 60-70% of the time.” They are obviously overestimating their capabilities. Still, these experts’ percentages pleased the female solution seeker, as meaningless as they were.
The male will seek a solution that will work 100% of the time, being less cautious with possible consequences of their robust action. They won’t fixate over warnings from experts, as they know their solution will definitely have a meaningful effect on the problem. They won’t dwell on the possible consequences either, because they know the consequences will be far to unknowable to predict. They will simply apply male solutions to any new problems that arise. When their solutions work, they are heroic, and when they fail, they are colossal failures.
We live in a society that values female solutions over male solutions. We measure, test, and evaluate every aspect of our solutions. We become over cautious, as unintended consequences become unacceptable. Female solutions are the minimal invasive effort, but still come with unintended consequences.
George Bush was often thought of as a cowboy, but his overall solution schemes where still largely female. This wasn’t Bush’s fault; it is just what is acceptable to American society. As he fought the Iraq war, he was mindful of many details that inhibited his army, such as civilian casualties. He took the blame for not predicting the unintended civil war after the initial victories. His adversaries had no such concerns; civilian casualties and unintended consequences where meaningless to the insurgents. The less calculated “surge” was a more male approach.
Different problems require different types of solutions. A lot of the mundane problems our society face may be adequately handled with female solutions. The oil spill is not one of them. As the problem continues, the ever increasing volume of leaked oil threatens more of the Gulf coast and eastern Florida. The new cautious solutions, if they work, will not be in effect until August. Even at that point, even if they work as planned, there still may be oil leaking.
It’s time for the male solution of the oil leak; nuke the site. Put a modest size nuclear bomb over the well head and set it off. The blast will push the oil down the well, and melt the pipe and the surrounding crust of the earth, closing off the hole. It will work 100% of the time. What will be the consequences of the blast? I don’t know. Perhaps they will be positive. Maybe the big pool of oil in the neighborhood of the well will be vaporized, never to be seen again. Maybe we will learn something about our nuclear weapons, as we haven’t tested them for years. BP will be happy to know that there is a 100% chance their annoying (to them) camera will be destroyed, never again to document every barrel of leaking oil in the corner of CNN’s screen.
Negative consequences will include loss of marine life, but maybe less so than if the oil keeps leaking, formation of possibly dangerous carbon chemicals, or perhaps a crack in the earth’s crust all the way down to the oil deposits, spilling the entire deposit into the Gulf. That would be a bummer. I personally think there is a 0% chance of an earth splitting catastrophe taking place, but I have no guess on how often I would be right on something like this. Rest assured, there is 100% chance that there will be some unforeseen, untoward consequence.
It has become clear that all the female solutions to the Gulf spill are time consuming and inadequate. It’s time to use the male solution. A nuclear success would make whoever approved it a hero. Do we have anyone with enough courage to apply a male solution to the oil spill? I think the chance that we do is 0%.
FDA: Be Careful With Flibanserine
May 25th, 2010A new drug, flibanserine, made by the German pharmaceutical company, Boehringer Ingelheim, will be considered by the FDA for approval next month. Originally it was hoped that flibanserine would be an effective antidepressant. Although it failed in this capacity, it was found to increase the sex drive in females. Flibanserine increases the brain levels of a powerful neuro active chemical called dopamine. Low levels of dopamine in the brain are thought to be the causation of Parkinson’s disease. Since drugs that increase levels of dopamine in the brain, such as L-dopa are prescribed for the treatment of Parkinson’s disease, their side effects are well known.
One side effect of L-dopa is “dopamine dysregulation syndrome” (DDS). From Wikipedia:
I have questions for the FDA. Are we trying to create a mild case of DDS in order to have more sex? Increasing levels of dopamine in the brain with L-Dopa has many other serious side effects; arrhythmias, disorientation, anxiety, vivid dreams or insomnia, hallucinations, and dyskinesia. Are we sure we are not going to see similar side effects with flibanserine over time?
Secondly, is flibanserine truly effective? Studies show minimal improvement in rates of sex over placebo. Is it possible that women who were taking the real product could tell that it wasn’t placebo through side effects they experienced, exaggerating the placebo effect; one reason that SSRI antidepressants where falsely found to be effective.
If flibanserine is effective, what effect will it have on relationships? Will women be more likely to have damaging affairs? This concern is not far out. Let’s pretend that she lives on an apricot farm, but she doesn’t care to eat apricots. She really would prefer to eat the apples from the farm down the road. She has managed to control herself so far, not eating much at all. Her family is upset that she doesn’t eat apricots, so they give her a drug that increases her appetite and limits her self control. Since apricots are not fulfilling her hunger, it is likely she will eventually wander off to the apple farm. The point is; if he isn’t satisfying her desire, he still won’t be satisfying her desire if her sexual desire is higher. With the higher sexual desire, less self control, and a built in excuse for bad behavior (“it was the drug that made me do it”) her forbidden fantasy may become a reality.
I am convinced that lack of sexual desire in females is not a chemical problem, but a relationship problem that can be effectively treated with education and behavior modification. Drugs with potential serious side effects, such as flibanserine, are not warranted. I hope the FDA acts cautiously when it considers approving flibanserine for an unsuspecting public.
Loss of Sexual Desire
May 22nd, 2010Dogs bark, babies cry, and married women lose sexual desire:
What Married Women Want More Than Sex
When we talk about women losing sexual desire as the marriage progresses, it is being compared to the hypersexual state when the couple was establishing their relationship. I submit that it is the hypersexual state that is abnormal for women, and not the comfortable low sexual desire married state. The analogy for men is the romantic state. While seeking a mate, men tend to become hypersensitive to the female’s needs, what we may call romantic. As the relationship becomes established, romance disappears. We have little trouble recognizing that the romantic state is the abnormal condition, why can’t we recognize the hypersexual state is abnormal?
There is ample evidence that the hypersexual state in females is recoverable; when women leave their established relationship and seek new ones, their hypersexual state quickly and reliably returns. Fortunately, less drastic action will also restore sexual desire.
Three primary changes in the relationship are the reason for the disappearance of the female hypersexual state:
1. Women use their sexuality to secure their relationship. Once the relationship is secured, there is little need for women to use their sexuality.
2. Freud would agree that forbidden relationships stimulate female sexual desire. While dating, there are forbidden aspects to the relationship that stimulate her desire. As the married relationship progresses, the familiarity of the relationship causes it to become less forbidden in her unconscious mind. With the loss of forbiddance, her true sexual desire becomes less stimulated.
3. Especially after having children; the male-female relationship often turns into more of a mother-child relationship. When she sees him as a child instead of a man, she will have little sexual desire for him; do to unconscious societal taboos against sexual feelings for children.
The loss of sexual desire in women represents a regression from the hypersexual state. In order to stimulate her sexual desire again, action on all three of the above reasons has to be initiated. Addressing these changes in the relationship will move her closer to the hypersexual state. Simply talking or communicating with her will improve many aspects of a relationship, but it won’t adequately restore her desire. My program at http://fhsdd.com, includes all the actions that are needed to address the issues of loss and restoration of sexual desire.
One more comment about the article. It included a suggestion that men also lose sexual desire in relationships. I find this is generally not true. Men lose the desire to be romantic, but retain sexual desire. The big test for men in relationships is retaining sexual fulfillment. My program also addresses this challenge.
Should Men do Housework?
May 17th, 2010Do real men do housework, or is it better that they do masculine things like hunting, and drinking beer with their friends. Men doing housework is a tremendous benefit to the health of most relationships. This fact is borne out by a British study:
Divorce less likely when men do housework
You may think it is important for men to do housework in order to take the heavy load off of their partners. Helping his partner at home is a noble thing for him to do, but the benefit to the relationship really has nothing to do with helping her. Being a man is a difficult role in our society. Political correctness shuns manly men and favors those who are more passive; or some may say more feminine. Most men, however, cannot be pressed into the feminine role. When they are not allowed to be men, they don’t become more feminine, they become children. The male-female relationship regresses into a mother-child relationship.
When women do all of the work at home, not only are they overworked; they start playing the role of his mother. He unconsciously remembers mother did all the cleaning, cooking, sewing, and caring for the children and everything else at home. The male starts seeing his partner as his mother and himself as her child. When a man sees his partner as his mother, he starts losing the ability to obtain sexual fulfillment from her, due to societal taboos against it. Just as problematic for the relationship, women start losing sexual desire for their partner when they see him as their child. When men are babied at home, the relationship suffers.
When men do housework, they are saying to themselves and their partner, “you are not my mother; I can feed myself, clean my surroundings, and clothe my body. I can also take care of the children so you clearly don’t have to be a mother to me.” This clear proclamation of manhood over childhood is what is so healthy for the relationship when men take part in housework. It lessens the mother role of his partner so she is able to see him as a man, and he is able to see her as not-mother, and obtain sexual fulfillment from her.
Women should take notice of and show appreciation when he takes charge of the relationship by helping at home. An appropriate way of displaying appreciation is with sexual interest in him. Besides, all work and no play will make him a dull boy.
Happy Marriage
May 12th, 2010What are the keys to a committed relationship, one that won’t succumb to infidelity? This article by Tara Parker-Pope in the New York Times tries to answer the question.
The Science of a Happy Marriage
a quote:
But it may not be feelings of love or loyalty that keep couples together. Instead, scientists speculate that your level of commitment may depend on how much a partner enhances your life and broadens your horizons – a concept that Arthur Aron, a psychologist and relationship researcher at Stony Brook University, calls “self-expansion.”
Do we really need a bunch of inane experiments to figure out what keeps couples together? Is having an enhancing, life broadening partner on anyone’s list of qualities that are important to them in relationships? Here are some real things that keep relationships together.
Sexual Fulfillment: How can sexual fulfillment not even be mentioned when it comes to infidelity? Men leave relationships because they are not sexually satisfied by their partner, not because she failed to enhance or broaden his life. An ongoing sexually fulfilling relationship is crucial to a lasting relationship. The challenge to relationships is how you maintain sexual fulfillment in a long term relationship. Those couples who rise to the challenge are the couples who stay together.
Love: I define love in a relationship as willing sacrifice for your partner. Love is not mushy feelings of tenderness, but a true commitment of sacrifice. When partners are committed to and accustomed to sacrificing for each other, they will more easily sacrifice selfish opportunities of flirtation, trysts, and infidelity. Another sacrifice of love is providing to your partner sexual fulfillment, and sacrificing the amount of sexual fulfillment that you require. The sacrifices of love are another pillar of lasting relationships.
Support: Family and friends who are supportive of the relationship are helpful, but the best support for a relationship is from God. The religiously devout family can turn to God in times of turmoil for the answers that will bind the relationship together. If both partners are intimate with God, they can’t help but be intimate with each other. We can become one when we both give ourselves to God.
These three arenas are not mutually exclusive, but work together to bind a relationship. Show me a relationship that has real love, sexual fulfillment and is blessed by God’s presence, and I will present to you a relationship that will last for eternity.
Raquel and Moral Decay
May 8th, 2010I have always admired the beautiful Raquel Welch. Here is her view on the current state of moral decay. There is not much more I can add.
Women Can’t Compete With an Iphone?
May 6th, 2010I love my iphone; so many of the apps are great. Divine Office has several prayer apps that are some of my favorites. I could easily spend an hour or two on the iphone daily if I didn’t have better things to do. Still; using the iphone doesn’t compare to having sex.
I find it hard to believe that some women are having difficulty competing with iphones.
The only thing I can say is that they must not be trying very hard. I’m sure that if they put the least bit of effort into it, 98 percent of men would respond. What is more likely is that they are using the iphone as an excuse not to have sex when they are not desirous of sex. The blame for not having sex is easily diverted to the iphone.
Sexual desire is a complicated thing in women. Many times the bother of sex is greater than their sexual desire. Going to sleep is often the chosen option. What is needed is an app on the iphone that will instruct the user to put the phone down when they are in bed and express a little interest in their partner. They may say “no” to sex, but at least Apple will be off the hook.