Characteristics of premenopausal and postmenopausal women with acquired, generalized hypoactive sexual desire disorder

Rosen, Raymond C.; Maserejian, Nancy N.; Connor, Megan K.; Krychman, Michael; Brown, Candace; Goldstein, Irwin

doi:10.1097/gme.0b013e318230e286

Cited by 37 publications

(27 citation statements)

References 24 publications

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“…In humans, the role of testosterone in female bone formation is still not well understood. As mentioned, it is clear that the majority of testosterone's effects in this decrease in testosterone has been implicated in postmenopausal decreases in libido, and possibly to hypoactive sexual desire disorder (HSDD), defined as a deficiency of sexual fantasies and desire for normal sexual activity that causes significant stress or interpersonal difficulty (89). In general, some studies suggest a correlation between serum testosterone levels and sexual desire (90, 91), but others do not (92,93).…”

Section: Androgen Action In Womenmentioning

confidence: 99%

Impact of estrogens in males and androgens in females

Hammes

Levin

2019

Journal of Clinical Investigation

143

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Section: Androgen Action In Womenmentioning

confidence: 99%

Impact of estrogens in males and androgens in females

Hammes

Levin

2019

Journal of Clinical Investigation

143

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“…A cross‐sectional, demographically representative U.S. population‐based survey conducted in 2006 found that approximately 1 in 10 premenopausal women reported low sexual desire with associated distress, which may indicate HSDD [2]. HSDD is believed to be the most common form of Female Sexual Dysfunction but remains underdiagnosed and undertreated [3–5].…”

Section: Introductionmentioning

confidence: 99%

Open-Label Extension Study of Flibanserin in Women with Hypoactive Sexual Desire Disorder

Jayne

Simon

Taylor³

et al. 2012

The Journal of Sexual Medicine

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Introduction Hypoactive Sexual Desire Disorder (HSDD) is a common form of Female Sexual Dysfunction characterized by low sexual desire that causes distress or interpersonal difficulty. Aim This 52-week open-label extension study aimed to assess the safety and tolerability of flibanserin, a postsynaptic 5-HT1A agonist/5-HT2A antagonist, in women with HSDD. Methods Women with HSDD who had completed a trial of flibanserin or flibanserin placebo received flexible-dose flibanserin (50 or 100 mg once daily at bedtime [qhs] or 25 or 50 mg twice daily [bid]) for 52 weeks. Main Outcome Measures Primary end points were: proportions of women with somnolence, sedation, fatigue, dizziness, nausea, and vomiting (adverse events [AEs] known to be associated with flibanserin); discontinuations due to AEs; and serious AEs. Secondary end points included change from baseline in Female Sexual Distress Scale-Revised total and Item 13 scores and Female Sexual Function Index (FSFI) total and desire domain score scores. FSFI total scores were used to classify women into FSFI remitters (FSFI score >26.55, indicating no clinical sexual dysfunction) and FSFI non-remitters (FSFI score <26.55). Results Of the 1723 women who received flibanserin, 962 (55.8%) completed 12 months’ treatment, and 883 women were exposed to flibanserin 100 mg qhs for ≥180 days. Somnolence, sedation, fatigue, dizziness, nausea, and vomiting were reported by 15.8, 1.6, 7.6, 6.9, 6.3, and 1.4% of participants, respectively. A total of 185 participants (10.7%) discontinued due to AEs. Serious AEs were reported by 1.2% of participants. At study end, 42% of baseline non-remitters had improved their FSFI score to remission level. The proportion of baseline FSFI remitters in remission rose from 83% at week 4 to a stable value of ∼90%. Conclusion Flibanserin was well tolerated. Sexual function improved in women who were not FSFI remitters at baseline, and was maintained in those who were remitters at baseline.

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“…In the Hypoactive Sexual Desire Disorder Registry for Women study, a large observational study of US women with clinically diagnosed generalized acquired HSDD, arousal disorders, lubrication problems, or both were reported by 50.2%, 42.5%, and 39% of women with HSDD, respectively. 48,49 A list of some potentially useful screeners and questionnaires is provided in the Supplemental Table (available online at http://www.mayo clinicproceedings.org).…”

Section: Modifiable Factorsmentioning

confidence: 99%

The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women

Clayton

Goldstein

Kim³

et al. 2018

Mayo Clinic Proceedings

Self Cite

180

131

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The International Society for the Study of Women's Sexual Health process of care (POC) for management of hypoactive sexual desire disorder (HSDD) algorithm was developed to provide evidence-based guidelines for diagnosis and treatment of HSDD in women by health care professionals. Affecting 10% of adult females, HSDD is associated with negative emotional and psychological states and medical conditions including depression. The algorithm was developed using a modified Delphi method to reach consensus among the 17 international panelists representing multiple disciplines. The POC starts with the health care professional asking about sexual concerns, focusing on issues related to low sexual desire/interest. Diagnosis includes distinguishing between generalized acquired HSDD and other forms of low sexual interest. Biopsychosocial assessment of potentially modifiable factors facilitates initiation of treatment with education, modification of potentially modifiable factors, and, if needed, additional therapeutic intervention: sex therapy, central nervous system agents, and hormonal therapy, guided in part by menopausal status. Sex therapy includes behavior therapy, cognitive behavior therapy, and mindfulness. The only central nervous system agent currently approved by the US Food and Drug Administration (FDA) for HSDD is flibanserin in premenopausal women; use of flibanserin in postmenopausal women with HSDD is supported by data but is not FDA approved. Hormonal therapy includes off-label use of testosterone in postmenopausal women with HSDD, which is supported by data but not FDA approved. The POC incorporates monitoring the progress of therapy. In conclusion, the International Society for the Study of Women's Sexual Health POC for the management of women with HSDD provides a rational, evidence-based guideline for health care professionals to manage patients with appropriate assessments and individualized treatments.

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Characteristics of premenopausal and postmenopausal women with acquired, generalized hypoactive sexual desire disorder

Cited by 37 publications

References 24 publications

Impact of estrogens in males and androgens in females

Impact of estrogens in males and androgens in females

Open-Label Extension Study of Flibanserin in Women with Hypoactive Sexual Desire Disorder

The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women

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