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Many marriages are breaking up because of a "desire discrepancy," where one partner wants to be intimate more than the other.
In some cases, there is an underlying medical problem behind a woman's low libido. Now a new drug is being tested in Salt Lake City to see if it will help.
Desperate for something to bring back her libido, Jackie is signing up to try a new drug.
"Give me the stuff I don't want the placebo!" Jackie jokingly told her doctor recently. She's working with Dr. Cynthia Bearensen, a clinical researcher with the LibiGel trial.
Dr. Bearensen says they are hoping it will be one of the first available therapies for low libido or Hypoactive Sexual Desire Disorder.
LibiGel is testosterone in the form of a gel that is applied to the upper arm, and Dr. Bearensen hopes these studies with LibiGel will allow them to get an FDA-approved form of testosterone for women.
Researchers will conduct two trials. One trial lasts six months, the other five years. The longer trial will look more closely at any cardiovascular risks with the drug.
Dr. Bearensen says they may sign up 24 women for each study in Utah and 3,500 women across the U.S. The study will take women over 30 who have either had their ovaries surgically removed or have gone through menopause.
"Men have this overriding testosterone usually, and women just don't have that. And when they take testosterone they get some, they can remember some of that biology why they might want to have sex," says. Dr Bearensen.
In the past there have been trials for a testosterone patch, but Dr. Bearensen says they want to see if this new gel form will help deliver the hormones to the bloodstream more effectively.
While past testosterone studies have proven effective for some women, Colette Malan took a different approach to her 20 years of low-sexual desire.
She said, "I made a turn around. I said from now on, I will tune in to me and find out what brings me authentic pleasure."
Her experience led her to become a sex therapist, and she and her husband, Dr. Mark Malan, both now practice together at the Malan-Porter Health Clinic in Ogden. They say women's sexual response is so complex a testosterone treatment like LibiGel is only a piece of the pie.
"The approach to treating women's sexual issues is very different," says Colette. "What works for men and women is different."
University of Utah Psychology Professor Dr. Donald Strassberg says couples also need to realize that nature also sometimes takes over. He says people often ask him how often they are supposed to be having sex. He says there isn't a "supposed to."
"Over time, the longer you are with the same partner and the more you age your, desire goes down. Not that anything is wrong," says Dr. Strassberg. "That's just the nature of long-term relationships. A lot of sex therapy really is sex education. A lot of what people learn is how normal they are."
He and Dr. D. Corydon Hammond, with the University of Utah Sex and Marital Service, say there are some women who do have low testosterone and for that a treatment like LibiGel may be very helpful. But Dr. Hammond says he's concerned people will just go for the medication instead of seeing if there's another problem associated with their low desire.
"I think Americans have become much too interested in a quick fix from a pill. My concern is every husband with a wife who isn't interested in sex as they are is going to be pressuring them to get this prescription. And that many physicians may not test testosterone levels before prescribing it," says Dr. Hammond. "It will have negative health implications. My understanding is that testosterone can increase how fast a cancer may grow and can cause sodium retention, which can increase blood pressure and have other kinds of medical implications."
He says if you fix the relationship, the physical intimacy will follow.
Dr. Hammonds adds, "Men who wish their wives had more sexual desire would be advised to look at, how romantic am I being? How much affection am I showing apart from sex? In what ways each day am I doing things to show I love you? How well do we communicate? How often do we sit down and talk on a feeling level and make eye contact and have some time alone with each other?"
Jackie and her husband have been learning this, and they say it is paying off.
"My husband gets up earlier than I do. He comes and wakes me up by kissing me on the neck and bringing me coffee. That's a big deal to me," says Jackie.
Dr. Bearensen says those are the types of things that make women want to have sex.
"Guys need to understand that," she says. "It's behavior outside of when they want to have sex that makes women sexual."
She continues, "Women are so stressed and busy, and they are taking care of little kids and sick parents and busy careers and relationship stuff and, oh my gosh, life is so complicated."
"I think we get very busy in life and very distracted with work, children, household chores, church responsibilities, and so on," says Dr. Hammond. "Too often sex gets what's left over at 11 o'clock at night, which isn't a whole lot."
"Women need to know that they are loved, and not so that their partners can have a sexual experience. And that turns them on," says Colette.
The bottom line for the subgroup of women clinically diagnosed with low testosterone is that LibiGel may help them get their drive back. But for the other women the answer may be a more complicated one.
Doctors say don't give up if you don't qualify for the medicine or if it doesn't work. Instead, talk to a physician, marriage counselor or sex therapist to see if there are other issues going on.
E-mail: mrichards@ksl.com
