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Since my last post on the #CatPerson story in The New Yorker, we have had numerous sexual stories come out including the babe.net piece in which a woman identified as Grace had with comedian Aziz Ansari which she described as sexual assault, the highly researched story in the WSJ of sexual misconduct and assault allegations against Steve Wynn and the NY Times’ Maureen Dowd interview with Uma Thurman

finally opening up in more detail regarding her sexual harassment allegations against Harvey Weinstein.

The Ansari story left the more than 2.5 readers split on what exactly the experience had been; consensual or coercive or assault? Grace wrote that her experience left her feeling violated while others have described the Ansari date as badly-mannered, insensitive badly communicated or plain ‘meh’ sex. The critical nature of the post #metoo movement requires a much more nuanced, articulate languaging of what is desired, what is possibly of interest, what is considered intrusive, coerced, and unwanted by both partners. The directives of consent need to be discussed at the beginning of an evening and then right before the sexual actions begin as well as during. Why? Since many people drink or use some sort of recreational drugs when hooking up, their ability to give consent changes over time, and especially if they are under the influence.

Have people gone too far in conflating bad sex in which people don’t take responsibility for what they do and don’t want with coercive sex and out-and-out assault in which a person is threatened physically and emotionally by the power of the other person? I think in the first wave of a reckoning the rage that had been building for so long can create a reaction that offers only a black and white, guilty/non-guilty verdict that does not reflect grey.

Given the upcoming Valentine’s Day when singles and newly dating couples go out to have fun, create some romance and potentially have some sexual fantasies in their expectations, I hope these further explicit discussion tips help to create a date that is remembered as sexually consensual, safe, sexy and sweet.

Dating Tips Post #CatPerson

Don’t Have Any Sexual Activity if You’re Drunk, Period!

While I think the main character Margot, a college student obviously regretted her decision to move ahead with having sex with Robert, the 30-something man she met at a university town bar, the sex was not coerced or forced by Robert. Similar to the real Grace of the babe.net story who thought Ansari would have more sensitivity about what she would want and not want to do given his public comedic routines about his avowed feminist identity, both these women had agreed to go ahead with a sexual scenario perhaps for different reasons.

In my sex therapy practice CLS, we frequently see heterosexual women who have felt like they should have sex with a guy for all sorts of reasons that have nothing to do with healthy sexuality. Some of these reasons include internal dialogues similar to what Roupenian wrote of Margot’s sudden erotic revulsion to the idea of having sex with Robert: “But the thought of what it would take to stop what she had set in motion was overwhelming; it would require an amount of tact and gentleness that she felt was impossible to summon.”

This is one of the key moments to this story. As a sex therapist one of the things I ask clients is to describe their last encounter slowly and describe not only their actions but their internal emotional and cognitive states as well. If these aren’t aligned then the sex will be experienced as mechanical, empty, ‘meh’ or bad. “Cat Person” is not a story of active coercion on Robert’s part, it’s not a story of an older man putting pressure on a younger woman, but it’s a story of woman incapable of expressing her desires in the moment that a certain sexual activity is signaled.

I think that many women related to this story because they felt they weren’t comfortable saying or didn’t have the education to say yes to some sexual activities and no to others.

In the #Catperson story Robert states: “You’re drunk” after she suggests they leave the bar for somewhere else. Margot is drunk and says: “No, I’m not,” though she knows she is. Where is her personal responsibility here? If one has enough awareness that one is drunk they need to state the fact, and go home by themselves. And where is Robert’s confidence in what he perceives as her state to non only insist on driving her home but actually following through and driving her home to wrest on the side of caution? I am not siding with either of these characters but actually holding both of them responsible for creating a safe, sober and perhaps more sexy encounter.

Check In with A Partner EACH STEP OF THE WAY During a Sexual Encounter

In my last blog I talked about all the ways partners can (sexily) describe what they’re interested in doing, what they’d consider and what are hard limits BEFORE a sexual encounter. What needs to be included in all enounters (whether they’re hookups or between longstanding partners) is a checking in along the way with the full understanding that THINGS CHANGE from moment to moment. Sex is a dynamic, living enactment of desires, fantasies, physical movements, that shift in the process.

In the #Catperson story Margot experiences a major shift in desire when she sees Robert bend down to take off his shoes after removing his shirt and pants.

“Looking at him like that, so awkwardly bent, his belly thick and soft and covered with hair, Margot recoiled.”

These moments happen a lot more often than people admit either to their friends afterwards or to themselves, even when someone isn’t drunk. And it’s okay to change your mind. Let me say this again, it’s okay to change your mind and tell someone: “I think I’m good for now” or “I would rather just cuddle” or “I’m not feeling well now and would like to remain clothed”. In the same way, you can say: “I’m good for now, would rather not drink any more”, without shame, or embarrassment or feeling so uncool or stiff.

But this is how Margot felt about the idea of letting him know her desire had changed:

But the thought of what it would take to stop what she had set in motion was overwhelming; it would require an amount of tact and gentleness that she felt was impossible to summon. It wasn’t that she was scared he would try to force her to do something against her will but that insisting that they stop now, after everything she’d done to push this forward, would make her seem spoiled and capricious, as if she’d ordered something at a restaurant and then, once the food arrived, had changed her mind and sent it back.

Margot (and Roupenian) likened the thought of changing her mind to the embarrassment of returning food at a restaurant and what he would think of her for doing so. This to me is the crux of the story because what so many female readers of this story have described is the pressure they feel in following a man’s directives during a sexual scenario or what they had originally stated (if they did at all) wanting at the beginning of an encounter.

The woman called “Grace” in the babe.net encounter with Aziz Ansari stated:

“He sat back and pointed to his penis and motioned for me to go down on him. And I did. I think I just felt really pressured. It was literally the most unexpected thing I thought would happen at that moment because I told him I was uncomfortable.”

One of the crises in our culture is this moment, the moment of asking and the moment of owning your authentic response. If Ansari was signal-blind, ignorant, drunk or plainly assertive in wanting what he wanted, Grace needed to say:

“Look, I’m really into your massaging my shoulders right now and that’s about it. I don’t want to go down on you, I don’t want to have penetrative sex, this is my limit now so please stop asking for more. It’s turning me off.”

What I hope is that my suggested statement above gets into the “sexual gray area between enthusiastic consent and resigned acceptance” as described by Carolyn Framke in the thoughtful Vox piece as the place the babe.net story fits in the conversation we are having in this post #metoo reckoning.

Know How to Say Yes, Thanks or No, Thanks or a Bit More of That

Whether it’s more sexual acts or the next date, be compassionate about your partner’s feelings. Many of my clients who are dating complain of ‘ghosting’ from people with whom they may have had long text threads, several dates or a 4 month-long relationship. Ghosting is the equivalent to not calling ever again, vanishing without a trace, or being stood up in the old days. One of the elements of Sex Esteem® which I teach to my groups is compassion. If you want to be treated with compassion by others, build a practice of compassion in all parts of your life. This means thinking about how the other person will feel, empathize with them without going beyond your limits and let them know if you’re done.

In The #CatPerson story, Margot avoids letting Robert know she is no longer interested. She thinks about ways to text him but perseverates about the perfect way to do it since they’d had sex but either texts excuses for not being in touch or ignores his texts altogether. And what Robert finally texts is what becomes one of the aspects of the story so many readers reacted to because of his inflammatory misogynistic message calling her “whore”.

Robert is a character, one we know about whom we know very little. But in this rageful, rejected pain expressed in this age-old insult for women who don’t give someone what they want, or who take their own sexuality into their own hands, or who reject someone who wants them, the story depicts a man who can be dropped into what many readers deem a bucket of deplorable men. That is the assumption that most men are perpetrators who you can’t trust. If Roupenian allowed the reader to get to know Robert, to figure out how this rejection triggered other old wounds perhaps, and offered him the opportunity to end by staying in the vulnerable state she had his character initially express when he didn’t hear from Margot, it might have offered a more dramatic view of a man than the original story offered. That of the male human who is openly hurt and vulnerable and remains in this expression.

“O.K., Margot, I am sorry to hear that. I hope I did not do anything to upset you. You are a sweet girl and I really enjoyed the time we spent together. Please let me know if you change your mind.”

Robert could have added: “I’m sorry you feel differently than I do.”

So if you have a date on Valentine’s Day or some time soon please try some of these Sex Esteem® steps before, during and afterwards. If you don’t feel you want to see the person again, think about ending with compassion and grace without malice, without humiliation, without sexist insults.

May we teach our children that speaking out without the fear of retribution is our culture’s new north star.”

Laura Dern on the Golden Globes

How to Fall in Love & Have Great Sex

September 14, 2017

Sari Cooper

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Mandy Len Catron recently published her book: How to fall in Love with Anyone: A Memoir in Essays, which explored the ingredients of closer intimacy. The book is based on her popular NY Times piece “To Fall in Love with Anyone, Do This”, where she reenacted the famous social experiment by psychologist Arthur Aron, “The Experimental Generation of Interpersonal Closeness: A Procedure and Some Preliminary Findings”, In the original psychological study, pairs of strangers spent 45 mins asking a series of 36 increasingly deep and personal questions in a lab setting. The purpose was to see if a sense of intimacy could be established in a relatively short amount of time. When Mandy Len Catron completed the questionnaire, she ended up forming a romantic relationship with a casual acquaintance.

Why did the 36 questions work so well for Catron personally and for many of the original study’s participants? I commented on this article when it first appeared on CBS This Morning but would like to expand on my observations here. The questionnaire starts off with seemingly innocuous inquiries, for example asking people to describe a perfect day scenario. Soon enough, the tone shifts to asking more serious questions such as best and worst life memories and views about death and mortality. Toward the end of the experiment, people are asked to share what they honestly feel about their partner and what they would like their partner to know if they wish to become close with them. After all the questions are answered, both participants then stare in each other’s eyes for about four minutes in silence. With each question, each participant is slowly becoming more vulnerable, exposing parts of themselves about which they feel embarrassed or anxious. These are aspects of oneself rarely shared with an acquaintance, let alone a complete stranger. As researcher Brene Brown has expressed: “Vulnerability is about showing up and being seen. It’s tough to do that when we’re terrified about what people might see or think”. And for those moments when one is finally truly seen, the desire to merge with them sexually may be activated as a further way to retain this emotional union.

In Catron’s original article she admits she was in a bar and drinking bar while undertaking this experiment. As an aside, many shy or introverted folks commonly use alcohol or recreational drugs as a social lubricant.

Unfortunately it may lead folks to a sense of false intimacy and potentially a consensual sexual experience that both people regret the next day. While I am not writing about non-consensual assault or rape here, I am clarifying that even with consensual sex under slight influence, the element of intimacy can be shrouded or missing.

Why This Works:

There are also some biological reasons as to why the study works in bringing people feeling closer. For example, research has shown that when people speak with direct eye gaze the listener is more likely to trust the speaker compared to a speaker looking elsewhere.

The ancient practice of Tantra includes eye-gazing as a method to encourage more relaxation and connection. Many partners find their breathing becomes aligned when gazing at one another’s eyes. In fact, our first instincts as babies is to look into our caretaker’s (parent’s) face for comfort and this is our way of calming our system and finding confidence in our world.

In a recent study out of the Kinsey Institute, researchers found that “over 50% of respondents ages 18-24 indicated that their most recent sexual partner was a casual or dating partner.” but they also found that “for all other age groups, the majority of study participants indicated that their most recent sexual partner was a relationship partner”. Even more fascinating, “men whose most recent sexual encounter was with a relationship partner reported greater arousal, greater pleasure, fewer problems with erectile function, orgasm, and less pain during the event than men whose last sexual encounter was with a non-relationship partner” . In another study, the researchers stated: “Men and women both were likely to report sexual satisfaction if they also reported frequent kissing and cuddling, sexual caressing by the partner, higher sexual functioning, and if they had sex more frequently.”

And for middle-aged men who reported having had more casual sex partners in their lifetime, they also reported less sexual satisfaction leading one to consider how deeper connections if combined with what I have coined as Sex Esteem® can lead to better discussions on what one desires, how one wants to grow in their sexual connection, and perhaps an emotional comfort that increases frequency.

This data illustrates that for many people, romance combined with sexual intimacy is an important recipe for sexual and relationship satisfaction for men and women (most of this research was based on heterosexual relationships). Does this mean that fulfilling sex cannot or should not occur outside a romantic relationship? Does it tell us that casual dating, sex with outside partners in a non-monogamous lifestyle or friends with benefits will not fulfill a person sexually? My answer is that it reports that for most straight folks, intimacy enhances their sexual pleasure AND that perhaps for some people sex without emotional intimacy is also pleasurable.

The clients we see at Center for Love and Sex range from monogamous couples who are so intimate it restrains their courage to request their desires, or couples who are locked in power struggles, bitter arguing or cold avoidance due to unresolved conflict so their sex life has been put on a shelf. We see people who are working on maintaining trust and intimacy in their primary relationship while openly exploring more sexually oriented partnerships outside the relationship.

Although American media frequently sets up a premise of casual sex as a titillating option in many movies, however the conceit quickly falls apart as the main characters “fall in love” by the end of the story. One can see examples of these situations in films like: Friends with Benefits, No Strings Attached or About Last Night. There is too often a one-size-fits-all script in terms of love and romance in Hollywood in which casual sex is shown to be too frail, less acceptable or not a true goal by the heroine or hero as the case may be. As a sex therapist I help clients discover what level of intimacy they’re looking for whether they’re single, married, or in a long-term relationship (whether it’s monogamous or contracted as non-monogamous). Some people rush into casual sexual agreements so quickly that they don’t spend time anticipating what feelings might get stirred up, or how to set up boundaries so that each partner doesn’t have ulterior or unconscious desires for a more romantic relationship. We use the therapy or coaching sessions to help people make realistic decisions given the type of person they are and what they’re looking for at this time in their lives.

Catron mentions another reason to her experiment’s success, which is the experience of love as an action as opposed to something that merely happens to someone externally . According to her, both she and her partner came to the experiment open and willing to take the steps to meeting someone new and falling in love. In addition, the study itself asked a series of questions that many long-term couples do not routinely ask one another, such as the last time a person cried alone or with another person. These types of questions may be considered too vulnerable even for couples who have been together for years. So I recommend learning to take the leap to connect deeply with vulnerability to someone through practicing vulnerability on a regular basis. Whether they’re your long-term partner, your spouse or someone you’ve recently began to see., the feeling of freedom and connection could be equally important to your emotional bond and increased sexual pleasure.

Sex Esteem® Holiday Tips for Feeling Sexy

November 24, 2015

Sari Cooper

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The holiday season is meant to be joyful and merry, but it often comes with a whole lot of stress and anxiety for Americans. I am lucky in that Thanksgiving is chosen holiday for me given that I was born in Canada and never celebrated any type of Thanksgiving until I moved to the U.S. So that history that others have with their childhood Thanksgivings and both the positive and the negative associations people have with them is not something I have. However, I am keenly aware how this holiday and the holiday season that follows next month stir up many people’s anxiety pot. Over the years I’ve helped clients in my private practice and coaching clients online to prepare before and process after the holiday. Holiday stress ends up affecting people in many ways, including their eating habits, how the food intake then affects their body image, and very frequently impacting their sex lives. Their Sex Esteem® can become impacted by the way they feel inside their body and how they focus on how they are perceived by others.

When it is time to reunite with family members, people often find themselves sinking back into the family patterns from childhood which may include misunderstanding, resentments and dysfunction they hoped would be left behind years ago. With family members reuniting, quizzing each other on their jobs, significant others, and recent accomplishments, it is far too easy to forget that this time of year is meant to be a time to rejoice and relax.

Eating disorders are more than twice as prevalent as they were 40 years ago, affecting up to 30 million Americans today (20 million women and 10 million men). When people are under stress from the marathon of holiday events they attend, they tend to miss out on much-needed sleep, which may lead to emotional eating. With appetizers, dinners, desserts and wine as center pieces, it is easy to get sucked into a holiday “diet”, leaving you even more stressed and self conscious than before. It is far too common to then feel heavier and weighed down, especially as the temperatures sink outside.

Messages and pictures from the media often influence and perpetuate body dissatisfaction and self-criticism. Americans watch, on average, three hours of television each day with commercials and shows containing subconscious as well as conscious messages that to convey an ideal of beauty and virility Female characters on TV, commercials and in films are unrealistically thin, busty, and curved in the right places, failing to represent what women truly look like. Photographs of models’ and actresses’ bodies are edited to make their breasts look bigger, waists smaller, and skin more flawless. Research has found a link between exposure to the thin ideal and unrealistic body types in the media to body dissatisfaction and disordered eating among women. In other words, the more women are exposed to the unrealistic body and beauty expectations of women through TV, ads, and other media, the worse they feel about themselves and the more likely they are to have unhealthy eating habits. In the end, women are left feeling self conscious and unhappy with their bodies.

In my practice, I have found that women who are self-conscious about their bodies are also unable to thoroughly enjoy sex with their partner, at times avoiding sexual encounters. The focus is taken away from feeling pleasure in their bodies as they ruminate over what they perceive as faults, or insufficiencies while in the act of sex. Research has shown that low body image and weight concern affect women’s sex drive. When women feel worse about their bodies, they are less sexually active and less able to become sexually aroused.

Increased drinking, combined with an inadequate amount of sleep, can all add up to feeling down, or a euphoric feeling that leads to eating more than one needs to be physically satiated. When one feels over-stuffed one has much less energy for sexual intimacy (which under good circumstances can feel pleasurable). I’m providing a warning to all you holiday revelers to resist the urge to alienate yourself from true holiday pleasure in your body, mind and heart which can result in feeling less sexual and most likely more isolated.

What can you do to feel healthier, sexier, and more active? Want to retain and build on the Sex Esteem® you have been growing through reading my blog? I urge you to be mindful of your relationship with stress and food at this time of year. It is important to be aware of your emotions and how you may be attempting to numb them by throwing a huge pile of stuffing and pumpkin pie on your plate. I invite you to think about your erotic self and how your inner mind wants to keep you feeling vital, passionate and connected. What are my holiday tips this year?

Begin the day by doing some sort of movement to get you in touch with your body, whether it’s some simple stretches, a walk or run outside, or a trip to the gym or a yoga class if that’s your thing.
Perhaps organizing a family tag football game will give you some running, some playing and some fun time with the extended family or friends before sitting down to the meal.

If you are feeling stressed with particular people at the gather, like your Uncle Tim and Aunt Lisa, focus on others with whom you connect more; like 8 year old cousin Brittany who wants to play house with you. If the tension becomes high for you, excuse yourself to take a little break outside to get some fresh air and breath deeply for 5 minutes. If you are working on goals to eat more healthily fill a smaller plate and resist the urges (your own and others’) to take seconds or thirds to satisfy an emotional need. Instead enjoy the flavors of the food by eating more slowly and mindfully.

In my new webshow Sex Esteem® on Youtube I discuss the power our senses have in our ability to turn ourselves on. For some the smells of pumpkin pie become a trigger for sex while others seek out the texture and flavors of homemade creamed spinach, mashed sweet potatoes, and turkey with a bit of gravy on the side. Think about what aspects of the holiday contain erotic triggers for you. If you aren’t cooking and are trying to keep to a healthier regimen, volunteer to bring along some healthy side like sauteed green beans or roasted asparagus.

If you are in a relationship It is important to prepare for the holidays by telling your partner about what concerns you have about the relatives you’ll be visiting, the menu and your personal food and alcohol goals and ask him/her to support you during the celebration. Check in with him/her before the meal and throughout to be in connection with each other. Discuss how much alcohol you plan to drink and how comfortable you feel at the table. If you’re both on the same page, having a buddy sticking to a plan is a great way to enjoy eachother and the holiday even more.

Initiate hugs and touching with your beloved sporadically throughout the day so that you are giving and receiving support, love, and connection. By creating an intimate plan with your partner, you are making sure that you will look after each other and know what to expect throughout the day.

Communicate ahead of time to find pockets of time you might have time (and privacy) for some sensual fun. It will keep one another grounded and connected in what may feel like a maelstrom of activity outside the bedroom. If you are single, try to sit next to the person with whom you feel closest. Be of service to those you love by helping out with the preparation of the food and or table. Giving hugs provides closeness to both those you hug and yourself.

Do not rush, and take time to savor every positive moment. The holidays are a time to reflect on your company, health, and positive relationships. Remind yourself what you are grateful for and what you love about yourself. Take a deep breathe and appreciate all that you have around you. Avoid overstressing and try to check back into what makes you happy. Remember that your emotional and sensual peace is much more significant than the size of your waist.

Addyi Passed by FDA; Will it Help Low Libido?

October 9, 2015

Sari Cooper

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This past August, the Food and Drug Administration (FDA) approved the first prescription drug designed to increase women’s sexual drive. Addyi (rhymes with Daddy, don’t ask me how they come up with these names), developed by Sprout Pharmaceuticals, has been dubbed the “Female Viagra.” However, unlike Viagra used primarily by men to help them with their erections and other PDE5 inhibitors which allow more blood flow to a penis, this medication works on the brain. Another important difference is that Viagra (and the medications for a man’s Erectile Dysfunction) is taken as needed and works pretty rapidly whereas Addyi is taken every day, much like an anti-depressant and one may not see improvement until 4 weeks have passed.

Addyi is being hailed as the first of its kind to treat the root of the issue formerly known as Hypo Sexual Desire Disorder (or HSDD), now called Female Sexual Interest/Arousal Disorder (FSIAD) in the new DSM 5 (Diagnostic and Statistical Manual)
in pre-menopausal women. The new DSM 5 merged the experience of not feeling frisky or interested with the experience of not being able to get physically aroused.

HSDD is characterized by low sexual desire that causes marked distress or interpersonal difficulty and is not due to a co-existing medical or psychiatric condition, problems within the relationship, or the effects of a medication or other drug substance. HSDD is acquired when it develops in a patient who previously had no problems with sexual desire. HSDD is generalized when it occurs regardless of the type of sexual activity, the situation or the sexual partner. (www.fda.gov)

Originally developed as an antidepressant, Addyi works on the neurotransmitters in the brain to increase desire. While it is without question that the FDA and pharmaceutical companies often discriminate towards women in drug development and manufacturing, before women across the United States can truly claim victory, there remain strong concerns that this miracle pill (dubbed the little pink pill as a marketing ploy to resonate with the little blue pill that is Viagra) might actually bring more harm than good.
One of the biggest concerns surrounding Addyi is whether the drug actually does what it claims. Approval for Addyi (when it was called Flibanserin) was actually previously rejected by the FDA twice – in 2010 and 2013 – for many reasons, including lack of effectiveness.

Even in the most recent studies, women taking Addyi only saw just one more sexually satisfying event (SSE) per month than those participants just taking the placebo. What my clients come in discussing is the loss of their intrinsic desire (or what some would call horniness, a physical tingling that alert them to their desire, an erotic fantasy or awareness that one is turned on) versus receptive desire (prompted by flirting, a fun date, or an intimate connection for example). Some in my field are not clear whether the Addyi study really were able to tell the difference in these types of issues by looking mainly at SSEs.

Moreover, many women do not realize the power their erotic mind has in boosting their drive and they do not understand that intrinsic physiologic triggers wear off naturally over time – which is why many in my field are asking whether we know enough about women’s desire to a) called it a medical pathology in the first place and b) offer them a medication versus educating women on other ways to increase their desire through other means? Considering that there was a high placebo effect in the study confirms my belief that some women need more education on how to enhance their erotic triggers besides intrinsic biological triggers.

In addition to the minimal evidence that the medication provides any substantial benefit to a woman’s sexual desire, I also share others concerns surrounding the side effects of this medication. As I mentioned above, the FDA previously rejected Addyi and another reason for those rejections were due to the high risk of side effects. First, there are the common side effects which including fainting, drowsiness, nausea, dizziness, and low blood pressure. While these are common for many other medications, women taking Addyi are also heavily counselled to abstain entirely from alcohol while on this medication because of the increased risk of severe hypotension and syncope due to the interaction between Addyi and alcohol.

The FDA felt so strongly about these side effects that each Addyi box will contain strong labeling highlighting these risks. Moreover, any doctor wishing to prescribe Addyi and any pharmacist that sells this medication must complete an online training course. It seems unrealistic to ask women – who may use alcohol as a means to relax prior to a sexual encounter – to abstain from alcohol and experience strong side effects from a pill that might only minimally increase their sexual arousal.

Finally, it also remains unclear that insurance companies will even cover Addyi. Some argue it would be equivalent to a monthly dose of traditional Viagra which is approximately $400, not an affordable medication for most folks. This means that even for a patient who does experience increased libido with no side effects, cost might continue to be a barrier. But pharmaceuticals are big business and when Sprout Pharmaceuticals was acquired by Valeant for $1 billion dollars, it was clear they were investing for a huge long-term gain on investment. You have probably heard about Valeant as recently as this past week, since it has reportedly raised the price on its brand name medications an average of 66% this past year.

While I am hopeful now that the FDA are taking women’s medical issues more seriously, and that they are interested in helping women who indeed have HSDD, I think we have to help women strengthen their Sex Esteem® by
a) figuring out if their low desire fits the criteria for the diagnosis of FSIAD
b) continuing to educate women on the many-layered causes for lower desire over long-term relationships
c) help them make an educated decision whether they need a medication.
d) ensure that they aren’t going to use alcohol when on the medication.