- Hypoactive sexual desire disorder (HSDD) affects about 30% of women and 15% of men.
- Researchers from Imperial College London in the United Kingdom say the hormone kisspeptin could be used to treat HSDD.
- Scientists found that kisspeptin helps improve sexual brain processing, boosting sexual responses in both men and women with low sex drive.
Hypoactive sexual desire disorder (HSDD) — where a person has an extremely low sex drive that causes them distress — affects about 30% of women and 15% of men.
Treatment options for HSDD include psychotherapy, sex therapy, lifestyle changes, medications, and hormonal therapies.
Adding to these choices, researchers from Imperial College London in the United Kingdom say the hormone kisspeptin could be used to treat HSDD by boosting their sexual response.
Two studies examining the effect of kisspeptin on HSDD were recently published in the journal JAMA Network Open — one focused on women and the other on men.
What is HSDD?
HSDD research suggests that it tends to affect more women than men. The condition may come on at any time and can either be a long-term issue or only occur in certain situations.
Those at a higher risk for HSDD include those with:
- low testosterone or estrogen levels
- diseases such as diabetes, heart disease, kidney disease, and thyroid disorders
- mental health concerns including depression, anxiety, and stress
- experiencing medication side effects
- relationship issues
- low self-esteem
- a smoking habit.
Symptoms of HSDD include:
- little to no sexual desire
- little to no sexual thoughts
- no interest in masturbation
- inability to be aroused
- no response to sexual signals
- inability to orgasm
- loss of erectile or ejaculatory function in men.
A person can have a low sex drive but not have HSDD. When a person has HSDD, it causes them distress.
Previous research finds people with HSDD have a lower quality of life, lower general happiness, and experience more negative emotions.
What is kisspeptin?
Kisspeptin is a naturally occurring hormone found in the hypothalamus region of the brain. It helps stimulate the release of other reproductive hormones in the body.
Past research shows that kisspeptin plays an important role in the female reproductive system, and it also helps regulate a person’s emotions and mood.
According to Dr. Alexander Comninos, honorary senior lecturer in the Department of Metabolism, Digestion and Reproduction at Imperial College London, consultant endocrinologist at Imperial College Healthcare NHS Trust, and co-senior author of the studies, about 10 years ago scientists realized that there was a lot of kisspeptin in areas of the brain related to sexual behavior.
“We tested this in healthy men and found that there was a boosting of sexual brain pathways,” he explained to Medical News Today. “Hence, we wanted to see if we could translate this to determine if giving kisspeptin could help individuals distressed about their low sexual desire.”
Dr. Comninos added there is currently a need for new treatment options for HSDD.
“Currently available treatments in [the] U.S, for women have limited effectiveness and carry significant side effects such as nausea, drowsiness, and interactions with alcohol,” he detailed.
“In men, there are no licensed treatments, as Viagra is predominantly a mechanical agent acting on the penis. Hence there is a significant unmet need to discover new safe and effective treatments for distressing low sexual desire,” Dr. Comninos explained.
Treating HSDD with kisspeptin
For these studies, researchers conducted two clinical trials — one with 32 premenopausal women and another with 32 men, all with an HSDD diagnosis. Participants underwent MRI brain scans, as well as blood and behavioral tests.
At the conclusion of the studies, researchers found men and women who received the treatment with kisspeptin experienced increased sexual brain processing, resulting in positive effects on their sexual behavior, compared to participants who had not received the hormone.
“Kisspeptin receptors are in the reward areas which control sexual desire in the brain,” Prof. Waljit Dhillo, an NIHR senior investigator in the Department of Metabolism, Digestion and Reproduction at Imperial College London. consultant endocrinologist at Imperial College Healthcare NHS Trust, and co-senior author of the studies told MNT.
“When men and women are looking at erotic images, their reward areas in the brain which control sexual arousal are more stimulated,” he explained.
“Our results suggest that giving kisspeptin can restore and even boost the brain balance related to sexual behavior,” Dr. Comninos added.
“It appears to suppress areas related to overthinking that are often overactive in HSDD and thereby release the brake on sexual arousal so they become more aroused. It was great to see that both women and men responded well to kisspeptin and in men, there was even a pro-erectile effect.”
– Dr. Alexander Comninos
When might the treatment be available?
For the next step in this research, Dr. Dhillo said that “[f]urther trials will be needed in a large group of patients taking it at home to see how effective it will be.”
Dr. Comninos agreed and said if further studies and development go well, we might see kisspeptin-based treatments for distressing low sexual desire in five to 10 years.
“Crucially, kisspeptin appears to be very well tolerated — we did not see any side effects in these studies,” he continued. “Interestingly, there also appear to be other beneficial effects of giving kisspeptin. We have performed early work suggesting that kisspeptin may also have beneficial effects on bones and the liver.”
Potential especially to help men
MNT also spoke with Dr. Barbara Chubak, associate professor of urology at the Icahn School of Medicine at Mount Sinai, about kisspeptin as a treatment option for HSDD.
She said she was pleased by the possibility of having another medication with which to potentially help men struggling with low sexual desire.
“HSDD is a problem that affects men and women alike, and one that can be present in the setting of normal sex hormone levels,” Dr. Chubak explained. “And HSDD — I suspect because of gender stereotyping — is the rare exception to the rule in medicine, where we actually have more treatments available for women than we do for men.”
“Currently, the only FDA-approved medications for HSDD are approved for pre-menopausal women; they are used off-label in men, but there is scant research data to support that use,” she continued.
“The use of testosterone to increase male sexual interest is more established, but typically unhelpful when the patient has normal testosterone level at baseline. We also often use erectile dysfunction medications (e.g. sildenafil) to compensate for the manifestation of low libido as [erectile dysfunction], but this can also be unhelpful, as these medications rely on the presence of sexual interest to prompt genital arousal response,” Dr. Chubak went on to say.
As for what she would like to see next in this research, she said scientists need to evaluate whether kisspeptin is a safe and effective treatment for HSDD.
“Additional important considerations for any new medication are ease of use — ideally in a form that can be self-administered by the patient themselves, rather than the intravenous bolus used in the study — and durability of effect,” she continued. “I look forward to seeing research along these lines in the future.”
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