Could a hormone spray reignite your love life?

Undeniably distressing to those affected, a lack of sexual desire is also a highly controversial topic.

Opinion is divided on whether it should be treated as a medical problem, and we don’t know exactly how many men and women are affected by it. Now, to add to the debate, scientists think they’ve discovered a treatment – a naturally occurring hormone called kisspeptin.

It could be the first drug to help both men and women with hypoactive sexual desire disorder (HSDD), the medical name for a low sex drive for more than six months that causes distress and has no medical cause.

Research shows that one in ten women and one in eight men suffer from it.

The problem can have a devastating effect, leading to depression, broken relationships and a poor quality of life.

Currently, those affected can be referred for talk therapies, such as cognitive behavioral therapy, but it doesn’t work for everyone.

Now new research by Imperial College Healthcare NHS Trust in London suggests that kisspeptin, a hormone that stimulates the release of other reproductive hormones from the hypothalamus in the brain, could be the answer.

Two recent studies, both published in the journal JAMA Network Open, found that when men and women with HSDD received an infusion of the hormone, it increased their sexual responses.

In both studies – one involving 32 premenopausal women and the other 32 men with HSDD – participants received a 75-minute infusion of the hormone and on another occasion a placebo (the participants were not told when they received kisspeptin, so to not affect the results).

They were then shown erotic videos and images of attractive faces and their brain activity was monitored via an MRI scan to assess their sexual responses; they also underwent blood and behavioral tests before and after treatment.

The results showed that kisspeptin improved sexual activity and arousal in women in parts of the brain that were disrupted in HSDD.

In addition, the more kisspeptin activated an important part of the brain (called the posterior cingulate cortex) in response to attractive male faces, the fewer women reported an aversion to sex.

Women also reported feeling “sexier” while receiving the kisspeptin infusions, compared to a sham treatment, according to mood and behavior tests.

In men, the hormone significantly increased brain activity in key areas related to sexual desire — while also increasing penile stiffness by up to 56 percent, compared to placebo while watching an erotic video.

Dr Alexander Comninos, a consultant endocrinologist at Imperial College Healthcare NHS Trust who was involved in the study, said: ‘These two studies provide the first evidence that kisspeptin is a potentially safe and effective therapy for both women and men with distressingly low sexual desire. . Kisspeptin has the potential to be a real game-changer.”

Low libido or low sex drive can be caused by a number of factors: low hormone levels (estrogen in women and testosterone in men is usually age related), depression, and as a side effect of certain medications such as beta blockers for blood pressure and opiate pain relievers. While people with hsdd also have little or no sex drive, a defining characteristic is that hsdd causes them great distress.

It was first identified in the psychiatrist’s bible, the Diagnostic and Statistical Manual of Mental Disorders, in 1987.

HSDD is linked to excessive self-control and concerns about sexual performance that reduce sexual desire, Dr. Comninos says.

“The main people seeking help are men and women aged 30 to 50,” he says. “Many men are incorrectly categorized as having erectile dysfunction when they really have HSDD.”

Kisspeptin is believed to work by deactivating the brain areas related to excessive self-control and introspection, while at the same time activating the sexual arousal centers.

There are no treatments available for HSDD in the UK (Viagra can help men get an erection by increasing blood flow, but doesn’t address the psychological aspect of sexual desire).

In the US, there are two medications for low sexual desire in premenopausal women. The first is bremelanotide (brand name Vyleesi), an injection given by yourself 45 minutes before sexual activity, which was originally designed for weight loss and activates receptors in the body related to sexual behavior.

The other drug, flibanserin (brand name Addyi), is a pill taken daily, originally developed as an antidepressant. It works by increasing levels of the brain chemicals dopamine and norepinephrine, which are important for sexual arousal. It also lowers serotonin levels, which can inhibit sexual desire.

However, both medications have side effects such as dizziness and nausea; and neither is licensed in the UK. In addition, HSDD remains a controversial diagnosis, with critics claiming it medicalizes normal variations in sexuality.

Dr. Christopher Lane, emeritus professor of medical humanities at Northwestern University in the US and author of the book Shyness: How Normal Behavior Became a Sickness, says: “Here is the risk that low sexual desire, which is common and often causes stress, merged. -related, with a new and still controversial psychiatric diagnosis.

“HSDD is not fully understood and there is a risk of assuming lack of desire to be a psychiatric condition rather than a psychological one,” he says.

“There are many facets that contribute to low libido; fear, stress, and disgust can all block desire. So is body dysmorphia, a condition in which a person spends a lot of time worrying about perceived flaws in their appearance.

This suggests that the primary cause of the condition may not be neurobiological [i.e. linked to the nervous system] and that, rather than resorting to drug therapies, the focus could be more usefully turned to finding ways to reduce stress and anxiety related to sex,” adds Dr. Lane.

Marianne Johnson, a psychosexual and relationship therapist at The Thought House Partnership in London, told Good Health: ‘Taking a drug to increase desire would understandably be very tempting for someone experiencing significant issues around their low libido.

“I hope that before turning to this type of medication, someone will have a chance to explore all the factors involved in their experience of low desire.

“Without any exploration of the bigger picture, there is the possibility of missing vital information about one’s internal world and their understanding of the blocks – and the accelerators – to their own liking.”

Dr. Comninos says it’s important not to “medicalize low sexual desire too much — in many people it’s not alarming and they don’t have HSDD,” but for others “it’s very distressing.”

He has received hundreds of emails from people with HSDD around the world, desperate to participate in research. “It can affect their daily quality of life, their mood, their personal and intimate relationships, and even their fertility if they don’t feel like having sex,” he says.

Larger studies of kisspeptin’s effects on sexual desire are now planned by the Imperial team – including in postmenopausal women.

Low libido is a common side effect of menopause, when levels of the hormone estrogen drop dramatically. This may persist even after low hormone levels have been treated with hormone replacement therapy (HRT).

The new study will examine whether postmenopausal women with low libido treated with HRT experience an increase in sexual desire after taking kisspeptin.

Researchers are investigating whether the hormone can be administered as a nasal spray, twice a week about half an hour before sexual activity. Future studies could also involve taking the hormone at home rather than in the hospital, which researchers hope will produce a “greater response” as people may feel more comfortable.

If future studies are successful, it could be available as a treatment “within the next five to 10 years,” says Dr. Comninos. “My vision is that over time, a couple could go on a date, the affected person takes a hit of the kisspeptin spray, and the evening ends with sex that they both enjoy,” he says.

“And because it’s effective for both men and women, I’m hopeful it works across the spectrum of genders and sexualities.”