Is low libido a disorder?

Excerpts from the Globe's blog on the Boston-area medical community.

Women's sexual problems - whether they care about them and, if they do, how to address them - are the subject of two studies that get to the heart of what qualifies as a medical disorder and what risks might be involved in taking drugs to treat them.

Dr. Jan Shifren, director of the Vincent Menopause Program at Massachusetts General Hospital, reported in Obstetrics and Gynecology that while almost half of women surveyed said they have sexual problems, about 1 in 8 said the problems caused them distress. The study was funded by pharmaceutical company Boehringer Ingelheim International, which makes a drug targeting women's low libido.

Shifren and her colleagues asked more than 31,000 women if they had difficulties with desire, arousal, or orgasm and whether these problems caused them unhappiness. About 43 percent said they had one or more problems, but 12 percent said they were troubled by them.

"You could certainly argue that something that occurs in 40 percent of otherwise healthy women is probably normative and we shouldn't be calling it a disorder," Shifren said in an interview.

The second, smaller study, appearing in the New England Journal of Medicine, examined women who did say their lack of desire was distressing. Procter and Gamble, makers of a testosterone patch used in the study, funded the trial and was also involved in its design, data collection, and data analysis.

About 800 postmenopausal women were randomly chosen to wear patches that delivered daily doses of high or low levels of testosterone or no hormone at all.

After a year, women who wore the higher-dose testosterone patch experienced a "modest but meaningful" improvement in their sex lives. That translates into 2.1 additional satisfying sexual encounters a month, the authors write.

Said Shifren: "Clearly it's only for that group of women for whom any potential risk would be justified."

ELIZABETH COONEY

Leaders of Massachusetts AIDS service organizations were warned last week to steel themselves for further cuts in spending on HIV treatment, prevention, and education amid deteriorating financial conditions.

Jarrett T. Barrios (left), a former state senator who is now president of the Blue Cross Blue Shield Foundation of Massachusetts, predicted that "there will be more cuts in December."

"It is not because this governor wants to make cuts," Barrios told several dozen people gathered Thursday for the annual meeting of the AIDS Action Committee of Massachusetts., the largest private provider of HIV services in New England. "It is because tax revenues are down."

Last month, the administration of Governor Deval Patrick cut more than $1 billion from the state budget in the wake of the nation's financial crisis. At the Department of Public Health, more than $1.5 million was excised from HIV and AIDS services.

At the federal level, Barrios said reductions may be forthcoming in the Ryan White HIV/AIDS Program, a major provider of dollars to state and local health agencies.

STEPHEN SMITH