Expert: Reproduction, Sexual Health Have Not Yet Been Separated When Discussing Women's Health

Pharmacy Times interviewed Rachel Rubin, MD, an assistant clinical professor in urology at Georgetown University, a urologic surgeon who specializes in the treatment of sexual dysfunction in both men and women, and one of only a handful of physicians trained in both female and male sexual medicine, on hypoactive sexual desire disorder (HSDD) and the current treatments available for this medical condition.

Alana Hippensteele: What are some of the common practices for the treatment of HSDD in women and men and are these treatments different for each sex?

Rachel Rubin: Yeah, it's a great question. When it comes to men, we actually don't—other than testosterone, which can help with libido and has been proven to help with libido—we actually don't have any other FDA-approved treatment options for low libido in men.

Whereas in women, post-menopausal women is where we have most of the data, but we don't have an FDA-approved testosterone for post-menopausal women. There is approval in Australia by their governing bodies for a testosterone for postmenopausal women. But we do have 2 FDA approved options for HSDD as a medical option for pre-menopausal women with HSDD or low libido, and that can be very useful as a tool for my patients.

Now I always have the tool of sex therapy, which no one doesn't benefit from sex therapy—right? Nobody is so good at sex they can't get better and get better at talking about it, so that is always a wonderful intervention that we have for our patients.

Alana Hippensteele: Why might research into treatments for sexual disorders in women have lagged behind that of similar research for such treatments in men?

Rachel Rubin: That is a loaded question and one I wish I had a glass of wine in my hand so I could speak more freely. Listen—women's sexual health—actually, a colleague of mine Dr. Maria Aluko made a really great point recently at a conference, and she said, as urologists, we have been trained to separate male reproduction from male sexual health. We don't talk about quality of life and sexual health for male patients, and it doesn't mean reproduction.

In women's health, reproduction and sexual health have not really been separated, and so we actually don't do a great job of talking about women as just sexual beings regardless of their reproductive health. I think we need to start moving in that direction, and I think we're about 20 years behind. We weren't that good at it with men until Viagra came out in 1998, and so I think we're about 20 years behind, but it's getting there. I mean, I think we are trying to create that change.