Hypoactive sexual desire in women.
OBJECTIVE
This review aims to describe low sexual desire (1) as a construct within theoretical models of female sexual response, (2) as a sexual disorder with evolving or competing nosology between the DSM-IV-TR and the DSM 5, and (3) as a clinical condition that healthcare providers need to manage, and the current status of treatment options.


METHODS
We conducted a literature review of the epidemiology, diagnosis, and treatment of low sexual desire/hypoactive sexual desire disorder (HSDD).


RESULTS
The prevalence rate of low sexual desire is high, reaching 43%, whereas that of HSDD comes close to 10%. The DSM 5 categories of female sexual disorders include female sexual interest/arousal disorder, which is a combination of the DSM-IV-TR disorders HSDD and female sexual arousal disorder. Treatment paradigms vary and are individualized based on the biopsychosocial components of desire that are compromised in a woman. The two primary approaches to treating HSDD are psychotherapy/sex therapy (individual or couples) and pharmacotherapy. To date, there are no Food and Drug Administration-approved pharmacologic treatments. However, four investigational drugs are in mid- to late-stage clinical trial development.


CONCLUSIONS
Low sexual desire is the most prevalent sexual problem in women and should be assessed and treated by healthcare professionals. Currently, there are only modest evidence-based nonpharmacologic treatment options and no approved pharmacologic options. Despite these treatment limitations, healthcare providers can address many of the sexual health concerns of women.
From the 1University Hospitals Case Medical Center, MacDonald Women's Hospital, Cleveland, OH; and 2Case Western Reserve University School of Medicine, Cleveland, OH.
Sheryl A
SA
Kingsberg
Roya L
RL
Rezaee
D001521:Behavior Therapy / Q000379:methods*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007989:Libido; D047648:Perimenopause; D012736:Sex Education / Q000379:methods*; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000628:therapy*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology / Q000628:therapy*; D016387:Women's Health