Circulating Androgen Levels and Self-Reported Sexual Function in Women

Davis, Susan R.; Davison, Sonia Louise; Donath, Susan; Bell, Robin J.

doi:10.1097/01.ogx.0000183601.95988.bc

Cited by 59 publications

(86 citation statements)

References 21 publications

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“…47 However, currently available assays have made it difficult to accurately measure testosterone levels in women, 48,49 and a large crosssectional study failed to show a significant relationship between testosterone levels and female sexual function. 50 Early studies established that testosterone therapy improved sexual function-primarily desire, arousal, and orgasmic response-in both naturally and surgically induced postmenopausal women. 48,51 In most studies, testosterone was used in conjunction with estrogen.…”

Section: Hormone Therapymentioning

confidence: 99%

Low Sexual Desire — Is it All in Her Head? Pathophysiology, Diagnosis, and Treatment of Hypoactive Sexual Desire Disorder

Simon¹

2010

Postgraduate Medicine

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Hypoactive sexual desire disorder (HSDD) is thought to be the most prevalent form of female sexual dysfunction (FSD), affecting up to 1 in 10 US women. Hypoactive sexual desire disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) as persistent or recurrent deficiency or absence of sexual fantasies and thoughts, and/or desire for, or receptivity to, sexual activity, which causes personal distress or interpersonal difficulties and is not caused by a medical condition or drug. This definition has recently received criticism and recommendations for changes encompass the inclusion of duration, intensity, and frequency, and the elimination of distress as a diagnostic criterion. More recently, it has been suggested that arousal and desire be combined into one disorder for the upcoming DSM-V. Causes of low desire include chronic medical conditions, medications, surgeries, and psychosocial factors, but not necessarily increased age; both pre- and postmenopausal women can have HSDD, although the frequency appears to vary by age. Sexual function requires the complex interaction of multiple neurotransmitters and hormones, both centrally and peripherally, and sexual desire is considered the result of a complex balance between inhibitory and excitatory pathways in the brain. For example, dopamine, estrogen, progesterone, and testosterone play an excitatory role, whereas serotonin and prolactin are inhibitory. Thus, decreased sexual desire could be due to a reduced level of excitatory activity, an increased level of inhibitory activity, or both. A number of validated self-report and clinician-administered instruments are available for assessing female sexual function; however, most have been used primarily in clinical research trials. The Decreased Sexual Desire Screener (DSDS) was developed for practicing clinicians who are neither trained nor specialized in FSD to assist in making an accurate diagnosis of generalized acquired HSDD. As our understanding of the pathophysiology of HSDD increases, it may become easier for physicians to identify and treat women with low sexual desire.

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Section: Hormone Therapymentioning

confidence: 99%

Low Sexual Desire — Is it All in Her Head? Pathophysiology, Diagnosis, and Treatment of Hypoactive Sexual Desire Disorder

Simon¹

2010

Postgraduate Medicine

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“…During the menopause, oestrogen levels decrease strongly. The testosterone concentration decreases gradually in women starting at the age of 25-30 years [21]. In postmenopausal women, testosterone levels are about half of what they were at the age of around 30 years.…”

Section: Modelsmentioning

confidence: 95%

Disorders in sexual desire and sexual arousal in women, a 2010 state of the art

Both

Laan

Schultz

2010

Journal of Psychosomatic Obstetrics & Gynecology

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In this contribution, female sexual desire and arousal disorders are viewed from the perspective of incentive motivation and information processing models of sexual response. The effects of hormones, somatic disease, and medication on sexual arousability are discussed, as well as the influence of psychological factors, such as stimulus meaning, mood and cognition, and relational context on female sexual desire and arousal. Specific topics to attend to during the anamnesis of sexual desire and arousal problems, and empirically evaluated psychological and pharmacological treatments for these problems are discussed.

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“…[43][44][45] In parallel, sexual desire declines with age. [40][41][42][43][44][45] It is logical to link these events. Decreased sexual desire has long been associated with endocrine disruptions that accelerate age-related loss ("reverse adrenarche") of endogenous androgen, such as oophorectomy, oral estrogen therapy, adrenal insufficiency, corticosteroid adrenal suppression, and hypopituitarism.…”

Section: Treatments For Fsd and Hsddmentioning

confidence: 99%

“…38,39 Thus, a mid-cycle increase in testosterone occurs in conjunction with the luteinizing hormone surge and is directly linked to increased mid-cycle sexual desire, which occurs during the reproductive years. Female aging is associated with a decline in endogenous testosterone production, [40][41][42][43][44][45] which may be accelerated under specific circumstances. [43][44][45] In parallel, sexual desire declines with age.…”

Section: Treatments For Fsd and Hsddmentioning

confidence: 99%

Hypoactive Sexual Desire Disorder in Premenopausal Women: Case Studies

Miner

Sadovsky

Buster

2012

Postgraduate Medicine

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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.

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Circulating Androgen Levels and Self-Reported Sexual Function in Women

Cited by 59 publications

References 21 publications

Low Sexual Desire — Is it All in Her Head? Pathophysiology, Diagnosis, and Treatment of Hypoactive Sexual Desire Disorder

Low Sexual Desire — Is it All in Her Head? Pathophysiology, Diagnosis, and Treatment of Hypoactive Sexual Desire Disorder

Disorders in sexual desire and sexual arousal in women, a 2010 state of the art

Hypoactive Sexual Desire Disorder in Premenopausal Women: Case Studies

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