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It's All in Your Mind. Maybe

By Dr. Pisaster | Posted Under Pajiba Dirty Talk | Comments (11)



low_libido1.jpg

The latest bit of sex-science related news to hit the interwebs is an MRI study that purports to detect differences in the brains of women with hypoactive sexual desire disorder (hereafter referred to as HSSD because I’m too lazy to type all that). Unfortunately, the research hasn’t actually been published yet. The principal investigator, Dr. Michael Diamond of Wayne State University, presented the study at the annual meeting of the American Society of Reproductive Medicine, and apparently has been talking to the media, but all the information that’s available about the study right now is second hand. Which is unfortunate, since lots of sites are picking up and spreading the news and the information about the study that is out there doesn’t seem to support the conclusions many reporters and bloggers are claiming it does.

Dr. Diamond and his colleagues ran MRI scans of 19 pre-menopausal women who had been diagnosed with HSSD and 7 women who had comparatively high sex drives (a very small sample, but not unusual for MRI studies). The women’s brains were scanned while they watched a television screen which alternated between showing neutral programming and erotica. The researchers found that the insular cortex in women who did not have HSSD lit up during erotic scenes while those of women with HSDD did not. The conclusion that’s being touted by the researchers is that HSDD is a real disease with real physiological causes, not something that’s “only in the mind,” which seems like kind of a weird thing to conclude from a study that only looked at responses in the brain.

Technically speaking they’re right of course, anything that affects the brain is physiological, despite our tendency to think of it as something separate from our physical bodies. But there’s nothing in the news reports that indicates that the differences in how women with HSDD’s brains react to erotic stimuli give any clue as to the source of the problem. It could in fact originate in the mind, just as depression does, for example, or it could be caused by something more global, like a hormonal imbalance. In fact, it seems most likely that there is actually more than one cause for HSDD, since many things, such as depression, hormonal birth control, and polycystic ovary syndrome are known to affect women’s libidos. Any of those things could be expected to produce the brain patterns seen in the study, since by definition having a low libido means subjects will not respond strongly to sexual stimuli. The researchers themselves don’t appear to be claiming that the brain effects they see are the cause of the disorder, but many outlets are reporting it that way, which is frustrating because it’s misleading. Even as the media is telling women their problem is real, they’re also sort of backhandedly saying it is, actually, all in their minds.

Another thing that bothers me about the news reports on this issue is the slightly sexist slant they take. Men can and do suffer from low sex drives as well, but no such studies seem to have been done to determine if the cause lies in their brain. Rather, Doctors are more likely to look for things like low testosterone levels, prostate issues, or pituitary tumors. It’s telling that researchers look at women’s brains and men’s bodies for what is essentially the same problem. I suspect that men with low sex drives would also not respond as strongly to erotica as men with high sex drives, but nobody is testing that. Scientists are human, and they bring their own biases into their research, especially when the subject involves human behavior in any way. Take for example, the way the brain activity is interpreted. The news reports state that the area of the brain that lights up in sexually responsive women is involved in processing and interpreting emotion, but it is also involved in perception of the body’s state and motor control, as well as a host of other things. The results are framed as an emotional effect (typical women, it’s all about emotions!), when they could just as easily have to do with miscommunication between the body and the brain. (The insular cortex, by the way, is also involved in the sensation of pain, and it lights up when subjects look at images of painful events. It would make sense if the sexual arousal response behaved similarly). Maybe the actual study has more detail on this, as well as information on other parts of the brain that may react differently in women with HSDD and those without it, but without seeing the study itself, it seems like the associations being drawn are inherently sexist.

It’s probably going too far to say that these results detect anything more than a symptom of low sex drive - the lack of response to visual sexual stimuli - at least based on the information present in the news. The difference in brain response does indicate that this disorder is a general problem with arousal and not indifference to a particular partner. That may not help much in treating the issue, but it might be comforting for both women who suffer from the disorder and their partners, since a person’s low sex drive can lead to their partner feeling rejected and cause a significant strain on relationships (and it’s just as bad when the person with the low sex drive is male, which is one of the reasons I wish the medical community didn’t think of this as a problem that affects only one sex). On the other hand, if these results hold up in further studies they may provide a way to detect if treatment for the disorder is working. It’s likely that drugs to treat HSSD will continue to take the route that flibanserin attempted, by tackling the brain (flibanserin was originally intended as an anti-depressant), so knowing which part of the brain is primarily affected by low sex drive might be useful, though that’s a very big might, since knowing which part of the brain is affected and knowing how to target that part of the brain are two different things. In the meantime, at least women (and men) suffering from HSSD have evidence that the problem is a physiological issue and not imaginary, even if it does turn out to be all in their heads.

Dr. Pisaster has a doctorate in biophysics, not actually anything sexy. She does however enjoy having sex, reading about sex, and talking about sex. Especially when she’s had a little whiskey.









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Comments

People misinterpret things that are written in plain English? Unpossible.

And men who don't wanna have sex all the time? Unpossibler.

Posted by: Slash at November 2, 2010 4:26 PM

Results of study....Most women don't get off on porn.

Pity.


Posted by: Skeetikus at November 2, 2010 4:38 PM

Michael Diamond?

When not busy recording and touring with the Beastie Boys, Mike D can be found at Wayne State University study human sexual dysfunctions.

Posted by: Rob at November 2, 2010 5:07 PM

This is really just another example of silver bullet thinking.

We want simple problems with simple solutions, so it's easy to pretend that these women just have a broken part in their brain and that we can give them a targeting drug and whammo! they're good to go.

All of this, of course, is typically ignorant of the fact that "targeted drugs" in the brain don't really mean what people think they mean. We're not necessarily hitting just one target, and it's not necessarily the source of the problem.

There's a lot of guilt by association involved in the way we treat the brain.

Posted by: ZombieScientist at November 2, 2010 5:07 PM

Skeetikus: so "19 pre-menopausal women who had been diagnosed with HSSD" = most women? Besides, since there's an entire movement within porn centering on films produced by and geared towards women, I'd estimate a fair number of women are watching (and enjoying) porn.

Dr. P makes an awesome point here, which is that there can be many different causes behind a low sex drive. Having gone through this myself, I can confirm that it's tough for both yourself and your partner.

Posted by: Becca at November 2, 2010 5:12 PM

If I am understanding this study correctly...The researchers found that women who report having low sex drives have less activity when shown porn. There's a shocker. Women who say they aren't usually aroused actually aren't aroused! I guess I'm glad there's proof that these women aren't just being contrary? "Heehee, I'm going to say I've got a low sex drive, but man, I'd like to have sex!" Woo...

Posted by: Phaeolus at November 2, 2010 6:07 PM

If it's all been in my head, I must have had an attitude readjustment lately. It has got to be physiological, because I'm pretty much the same person, but at late 30's all of a sudden I'm skippy boom-de-ada and everywhere looks fun to sit.

I'm gonna be really grumpy, trust me, if it all goes away like I used up my last Chocobo Lure.

Posted by: replica at November 2, 2010 8:48 PM

replica, this study doesn't show anything one way or the other, in terms of being "all in your head". All this shows, at least what was said above, is that women with HSSD have a different response in their insular cortex than the other women. We have no idea what step in the pathway to "let's get it on" is different. Since the insular cortex gives the brain info about the body, it could be a result of HSSD, not a cause (i.e., the usual cortex activity is "hey, I'm wet", while the lack of activity simply means "no dampness here!")

That's why the mention of targeted drugs is kind of scary, since we have no idea what step in the response is broken, or how many other things this insular cortex activity affects. Maybe it's psychological, and is affecting the brain activity. Maybe there's a problem in the insular cortex itself. Maybe there's a physiological problem that is causing the lack of activity. Maybe there's a problem somewhere else in the brain that's affecting the insular cortex.

Posted by: Phaeolus at November 3, 2010 12:06 AM

Wouldn't hypoactive sexual desire disorder be HSDD, not HSSD?

Posted by: Matt at November 3, 2010 1:51 AM

Phaeolus, isn't it awful how everything gets those shitty antidepressant 'we don't know how, why, or if they work or are dangerous or what, but take it and see' drugs suggested for everything? Those damn things almost killed me both times I've used them - once for a sad phase and once for attempted smoking cessation. Now I'm so scared of pharmacology and drugs I'll only take a scrip if it's that or die - for absolute certain.

Posted by: replica at November 3, 2010 4:01 AM

Matt -doh. Yes it would. This is what happens when you rely on spellcheck to catch your stupid mistakes.

Posted by: dr. pisaster at November 3, 2010 12:13 PM