Hypoactive sexual desire disorder in premenopausal women: case studies.
Hypoactive sexual desire disorder (HSDD) is the most common female sexual dysfunction (FSD) and is thus frequently encountered in the primary care provider and OB/GYN practices. Causes of low sexual desire may be hormonal, neurologic, vascular, psychologic, or a result of illness/surgery or medications. The condition is often left untreated because both women and clinicians feel embarrassed to bring up the topic and believe that there is no available treatment. The use of short, validated questionnaires, such as the Decreased Sexual Desire Screener, to be completed in the waiting room, can open up discussion between provider and patient. In addition, 2 other algorithms are designed for clinicians who are not specifically trained in FSD and can help in diagnosing and managing a broad range of conditions related to FSD. Treatment for low desire consists primarily of patient education and counseling, as well as treatment of underlying comorbid conditions, such as diabetes, obesity, or cancer. While testosterone products are approved in Europe for use in surgically postmenopausal women with HSDD, in the United States, no pharmacologic treatments are approved for the treatment of HSDD or any FSD. Testosterone products are being used off-label, but questions remain about their efficacy and safety in pre- and postmenopausal women. This article gives an overview of HSDD in clinical practice and provides 3 case descriptions to illustrate the treatment of low sexual desire in women with diverse histories.
Miriam Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI 02906, USA. martin_miner@brown.edu
Martin
M
Miner
Richard
R
Sadovsky
John E
JE
Buster
D000328:Adult; D000728:Androgens / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects; D001943:Breast Neoplasms / Q000150:complications / Q000628:therapy; D005260:Female; D006801:Humans; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D010052:Ovariectomy; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D017697:Premenopause; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000627:therapeutic use
D000728:Androgens; D000970:Antineoplastic Agents; D013739:Testosterone