@home: a study to investigate the subjective and physiological efficacy and safety of Lybrido and Lybridos in the domestic setting in healthy female subjects with Female Sexual Dysfunction and SSRI usage.

- For inclusion in the study, heterosexual women (pre-, and postmenopausal) with Hypoactive Sexual Desire Disorder (HSDD) in combination with SSRI use must fulfil the following criteria:



1. Provision of written informed consent.

2. Female 21 – 70 years of age with Hypoactive Sexual Desire Disorder and/or SSRI induced sexual disfunctioning (comorbidity with Female Sexual Arousal Disorder (FSAD) and/or orgasmic disorder is allowed); subjects must have experienced low sexual desire for at least one month prior to study entry according to DSM IV criteria. The diagnosis will be made by an experienced psychologist/sexologist.

3. Usage of a SSRI for at least 3 months.

4. The SSRI must be on a stable dose for at least 6 weeks.

5. Healthy according to normal results of medical history, physical examination, laboratory values and vital signs, unless the investigator considers an abnormality to be clinically irrelevant.

6. Subjects must have a heterosexual relationship.

7. Subjects must have developed HSDD before using SSRIs or developed HSDD during the usage of a SSRI.

- Any of the following is regarded as a criterion for exclusion from the study.



1. Use of oral contraception containing anti-androgens (Like Diane 35 or Minerva);

2. Use of oral contraception containing 50 μg estrogen or more;

3. Pregnancy, or intention to become pregnant during this study (Note: a serum or urine pregnancy test will be performed in all women prior to the administration of study medications);

4. A pelvic inflammatory disease or an untreated vaginal infection at screening;

5. Lactating or subjects who have given birth in the previous 6 months;

6. Previous prolapse and incontinence surgery affecting the vaginal wall;

7. Women with other unexplained gynecological complaints, such as abnormal uterine bleeding patterns;

8. History of endocrinological treatment or current endocrinological treatment (with the exception of the use oral contraceptives and of fertility-promoting treatment);

9. History of neurological treatment or current neurological treatment;

10. History of serious psychiatric treatment (e.g.,schizophrenia, psychosis) or current major depression;
11. Any underlying cardiovascular condition including unstable angina pectoris, that would preclude sexual activity;

12. History of myocardial infarction, stroke or life-threatening arrhythmia within the prior 6 months;

13. Uncontrolled atrial fibrillation/flutter at screening (ventricular response rate > 100 bpm), or other significant abnormality observed on ECG;

14. Systolic blood pressure > 140 mmHg and/or diastolic blood pressure > 90 mmHg. For subjects with age > 60 years and without diabetic mellitus, familiar hypercholesterolemia or cardiovascular disease: Systolic blood pressure > 160 mmHg and/or diastolic blood pressure > 90 mmHg (According to the CBO-guideline hypertension (CBO.2000a)). Systolic blood pressure < 90 mmHg and/or diastolic blood pressure <50 mmHg;

15. Subjects who are taking strong CYP3A4-inhibitors: ritonavir (HIV-proteaseremmer), ketoconazol en itraconazol;
16. Subjects who are taking less strong CYP3A4-inhibitors: claritromycine, erytromycine en saquinavir;

17. Subjects who are taking CYP3A4-inducers: carbamazepine, fenytoïne, fenobarbital, st Johns Wort, rifampicine;

18. Severe chronic or acute liver disease, history of moderate (Child-Pugh B) or severe (Child-Pugh C) hepatic impairment;

19. Use of medicinal herb as Ginkgo Biloba, St John's wort and nutrition containing grapefruit; avoid valerian, gotu kola, kava kava (may increase CNS depression);

20. Subjects who are taking nitrates or nitric oxide donors;

21. Subjects who are taking MAO inhibitors (includes classic MAO inhibitors and linezolid), Calcium channel blockers (e.g. Diltiazem and verapamil), Nefazodone, , TCAs, Tramadol, any medicine belonging to the triptans (i.e. sumatriptan);

22. A substance abuse disorder that in the opinion of the investigator is likely to affect the subject's ability to complete the study or precludes the subject’s participation in the study; mild or moderately alcohol drinking behavior is allowed, only 12 hours before the experimental days is alcohol drinking not allowed. Three weeks before the start of the experimental day is the taking of any recreational drug not allowed. Smoking is allowed;

23. Use of any treatment for FSD within the 7 days before visit 1 or during the study, including oral medications or constrictive devices;

24. Subjects who are illiterate, unwilling or unable to understand and complete the questionnaires;

25. Any other clinically significant abnormality or condition which in the opinion of investigator would interfere with the participant’s ability to provide informed consent, comply with study instructions, possibly confound interpretation of study results, or endanger the participant if she took part in the trial;

26. Subjects who do not have easy access to a/their partner (for example because the partner works on a drilling platform at sea);

27. Subjects who are experiencing vision impairment, like partial or complete blindness or color blindness;

28. Subjects with a body mass index (BMI)>35 kg/m2;

29. Subjects who do not have easy access to the internet;

30. Subjects with a peri menopausal hormonal status.