Dr. Goldstein discusses the latest research being conducted on women's sexual health.
Some of the latest research on women’s sexual health has been published in of course the Journal of Sexual Medicine which comes out of here in San Diego, and it’s the official journal for the International Society for Sexual Medicine, and also for women’s sexual health, the official Journal of the International Society for the Study of Women’s Sexual Health.
I can think right off the cuff of two major manuscripts that I think are awesome. The first one is pre-menopausal women, and the fact that those women who are pre-menopausal, who have the physical conditions of diabetes and/or high cholesterol and/or low thyroid function, are demonstrating to show low sexual function based on validated questionnaires. Why is that so important?
We have always thought that there is a predilection towards women’s sexual health concerns being psychologic. We have sort of found that in men’s sexual health issues there is a lot of risk factors – diabetes, hypertension, cigarette smoking being extremely common – and that means they are physiologic forms of men’s sexual issues.
We are just starting to understand the physiologic forms of women’s sexual issues, and we are now coming to similar data. Men and women with diabetes, men and women with high cholesterol, men and women with hormonal issues such as low thyroid are showing low sexual function.
So a little more of research, this is the first time we have ever seen showing some of the similar vascular risk factors, especially in younger women, this is pre-menopausal, are showing low sexual function; wonderful paper--many more to come.
Second important paper was performed in a group of women around 20 with no history of sexual dysfunction, what we call NHSD. In women with HSDD–those are the women with the low interest--and they did what’s called functional magnetic resonance imaging. So they went inside this MRI unit, and they were monitoring the regions of the brain where blood was going, following viewing of a video.
Actually, there was a series of videos, contrasting videos of erotic versus non-erotic video, and what was totally fascinating, it was the women with no history of sexual dysfunction had beautiful regions of the brain pop up when exposed to certain material, and that exact same material showing to women with HSDD had different regions of the brain light up.
And basically as we come to better understand the central dysregulations involved in sexual health concerns, you can argue that you have a road; you make a left turn and you go to this nice fancy restaurant where you really want to go, but sometimes you can’t really make a left. You are forced to go to the right, and you end up at McDonald’s, and it isn’t sort of what you really want, but you make do of it.
As we understand, there are chemicals in the brain that sort of shift you to sending blood to the regions that you want. That would be good, but unfortunately, sometimes for psychologic or perhaps biologic chemical deficiency states you get shifted to the wrong blood flow areas, and this new drug that I, that we just discussed that hopefully will come out in the year 2010 at least early enough to be used by many people, will help the diversion to the correct and hopeful, satisfying approach towards rehabilitation of the sexual problem.
So we are better understanding the chemicals in the brain and how they get dysregulated. It’s extremely common concept. Men and women who have Tourette’s Syndrome have these odd movements that they can’t control or people who are horribly depressed, we use pharmacologic strategies to better regulate the brain’s function, and we now add to this common theme, women with low sexual interest, that have been unable to be improved with more traditional treatments like sex therapy or diet or exercise or acupuncture or those kinds of things.
About Dr. Goldstein, M.D.:
Dr. Irwin Goldstein is Director of San Diego Sexual Medicine at Alvarado Hospital, the Secretary of the International Society for the Study of Women’s Sexual Health, a former President of the Sexual Medicine Society of North America and a Clinical Professor of Surgery at University of California at San Diego.
Dr. Goldstein has been involved with sexual dysfunction research since the late 1970s. His specialties include penile microvascular bypass surgery, surgery for dyspareunia, physiologic investigation of sexual function in men and women, and diagnosis and treatment of sexual dysfunction in men and women.