Evaluation and Management of Hypoactive Sexual Desire Disorder

Hypoactive sexual desire disorder (HSDD) often has a negative impact on the health and quality of life of women; however, many women do not mention—let alone discuss—this issue with their physicians. Providers of gynecologic services have the opportunity to address this subject with their patients....

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Published inSexual medicine Vol. 6; no. 2; pp. 59 - 74
Main Authors Clayton, Anita H., Kingsberg, Sheryl A., Goldstein, Irwin
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.06.2018
Elsevier
Oxford University Press
Subjects
Diagnosis
Drug Therapies
Flibanserin
Hypoactive Sexual Desire Disorder
Review
Screening
Sexual Dysfunction
Sexual Dysfunction
Screening
Hypoactive Sexual Desire Disorder
Diagnosis
Drug Therapies
Flibanserin
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Abstract Hypoactive sexual desire disorder (HSDD) often has a negative impact on the health and quality of life of women; however, many women do not mention—let alone discuss—this issue with their physicians. Providers of gynecologic services have the opportunity to address this subject with their patients. To review the diagnosis and evidence-based treatment of low sexual desire in women with a focus on strategies that can be used efficiently and effectively in the clinic. The Medline database was searched for clinically relevant publications on the diagnosis and management of HSDD. HSDD screening can be accomplished during an office visit with a few brief questions to determine whether further evaluation is warranted. Because women’s sexual desire encompasses biological, psychological, social, and contextual components, a biopsychosocial approach to evaluating and treating patients with HSDD is recommended. Although individualized treatment plan development for patients requires independent medical judgment, a simple algorithm can assist in the screening, diagnosis, and management of HSDD. Once a diagnosis of HSDD has been made, interventions can begin with office-based counseling and progress to psychotherapy and/or pharmacotherapy. Flibanserin, a postsynaptic 5-hydroxytryptamine 1A agonist and 2A antagonist that decreases serotonin levels and increases dopamine and norepinephrine levels, is indicated for acquired, generalized HSDD in premenopausal women and is the only agent approved in the United States for the treatment of HSDD in women. Other strategies to treat HSDD include using medications indicated for other conditions (eg, transdermal testosterone, bupropion). Bremelanotide, a melanocortin receptor agonist, is in late-stage clinical development. Providers of gynecologic care are uniquely positioned to screen, counsel, and refer patients with HSDD. Options for pharmacotherapy of HSDD are currently limited to flibanserin, approved by the US Food and Drug Administration, and off-label use of other agents. Clayton AH, Kingsberg SA, Goldstein I. Evaluation and Management of Hypoactive Sexual Desire Disorder. Sex Med 2018;6:59–74.
AbstractList INTRODUCTIONHypoactive sexual desire disorder (HSDD) often has a negative impact on the health and quality of life of women; however, many women do not mention-let alone discuss-this issue with their physicians. Providers of gynecologic services have the opportunity to address this subject with their patients. AIMTo review the diagnosis and evidence-based treatment of low sexual desire in women with a focus on strategies that can be used efficiently and effectively in the clinic. METHODSThe Medline database was searched for clinically relevant publications on the diagnosis and management of HSDD. RESULTSHSDD screening can be accomplished during an office visit with a few brief questions to determine whether further evaluation is warranted. Because women's sexual desire encompasses biological, psychological, social, and contextual components, a biopsychosocial approach to evaluating and treating patients with HSDD is recommended. Although individualized treatment plan development for patients requires independent medical judgment, a simple algorithm can assist in the screening, diagnosis, and management of HSDD. Once a diagnosis of HSDD has been made, interventions can begin with office-based counseling and progress to psychotherapy and/or pharmacotherapy. Flibanserin, a postsynaptic 5-hydroxytryptamine 1A agonist and 2A antagonist that decreases serotonin levels and increases dopamine and norepinephrine levels, is indicated for acquired, generalized HSDD in premenopausal women and is the only agent approved in the United States for the treatment of HSDD in women. Other strategies to treat HSDD include using medications indicated for other conditions (eg, transdermal testosterone, bupropion). Bremelanotide, a melanocortin receptor agonist, is in late-stage clinical development. CONCLUSIONSProviders of gynecologic care are uniquely positioned to screen, counsel, and refer patients with HSDD. Options for pharmacotherapy of HSDD are currently limited to flibanserin, approved by the US Food and Drug Administration, and off-label use of other agents. Clayton AH, Kingsberg SA, Goldstein I. Evaluation and Management of Hypoactive Sexual Desire Disorder. Sex Med 2018;6:59-74.
Hypoactive sexual desire disorder (HSDD) often has a negative impact on the health and quality of life of women; however, many women do not mention-let alone discuss-this issue with their physicians. Providers of gynecologic services have the opportunity to address this subject with their patients. To review the diagnosis and evidence-based treatment of low sexual desire in women with a focus on strategies that can be used efficiently and effectively in the clinic. The Medline database was searched for clinically relevant publications on the diagnosis and management of HSDD. HSDD screening can be accomplished during an office visit with a few brief questions to determine whether further evaluation is warranted. Because women's sexual desire encompasses biological, psychological, social, and contextual components, a biopsychosocial approach to evaluating and treating patients with HSDD is recommended. Although individualized treatment plan development for patients requires independent medical judgment, a simple algorithm can assist in the screening, diagnosis, and management of HSDD. Once a diagnosis of HSDD has been made, interventions can begin with office-based counseling and progress to psychotherapy and/or pharmacotherapy. Flibanserin, a postsynaptic 5-hydroxytryptamine 1A agonist and 2A antagonist that decreases serotonin levels and increases dopamine and norepinephrine levels, is indicated for acquired, generalized HSDD in premenopausal women and is the only agent approved in the United States for the treatment of HSDD in women. Other strategies to treat HSDD include using medications indicated for other conditions (eg, transdermal testosterone, bupropion). Bremelanotide, a melanocortin receptor agonist, is in late-stage clinical development. Providers of gynecologic care are uniquely positioned to screen, counsel, and refer patients with HSDD. Options for pharmacotherapy of HSDD are currently limited to flibanserin, approved by the US Food and Drug Administration, and off-label use of other agents. Clayton AH, Kingsberg SA, Goldstein I. Evaluation and Management of Hypoactive Sexual Desire Disorder. Sex Med 2018;X:XXX-XXX.
Hypoactive sexual desire disorder (HSDD) often has a negative impact on the health and quality of life of women; however, many women do not mention—let alone discuss—this issue with their physicians. Providers of gynecologic services have the opportunity to address this subject with their patients. To review the diagnosis and evidence-based treatment of low sexual desire in women with a focus on strategies that can be used efficiently and effectively in the clinic. The Medline database was searched for clinically relevant publications on the diagnosis and management of HSDD. HSDD screening can be accomplished during an office visit with a few brief questions to determine whether further evaluation is warranted. Because women’s sexual desire encompasses biological, psychological, social, and contextual components, a biopsychosocial approach to evaluating and treating patients with HSDD is recommended. Although individualized treatment plan development for patients requires independent medical judgment, a simple algorithm can assist in the screening, diagnosis, and management of HSDD. Once a diagnosis of HSDD has been made, interventions can begin with office-based counseling and progress to psychotherapy and/or pharmacotherapy. Flibanserin, a postsynaptic 5-hydroxytryptamine 1A agonist and 2A antagonist that decreases serotonin levels and increases dopamine and norepinephrine levels, is indicated for acquired, generalized HSDD in premenopausal women and is the only agent approved in the United States for the treatment of HSDD in women. Other strategies to treat HSDD include using medications indicated for other conditions (eg, transdermal testosterone, bupropion). Bremelanotide, a melanocortin receptor agonist, is in late-stage clinical development. Providers of gynecologic care are uniquely positioned to screen, counsel, and refer patients with HSDD. Options for pharmacotherapy of HSDD are currently limited to flibanserin, approved by the US Food and Drug Administration, and off-label use of other agents. Clayton AH, Kingsberg SA, Goldstein I. Evaluation and Management of Hypoactive Sexual Desire Disorder. Sex Med 2018;6:59–74.
Abstract Introduction Hypoactive sexual desire disorder (HSDD) often has a negative impact on the health and quality of life of women; however, many women do not mention—let alone discuss—this issue with their physicians. Providers of gynecologic services have the opportunity to address this subject with their patients. Aim To review the diagnosis and evidence-based treatment of low sexual desire in women with a focus on strategies that can be used efficiently and effectively in the clinic. Methods The Medline database was searched for clinically relevant publications on the diagnosis and management of HSDD. Results HSDD screening can be accomplished during an office visit with a few brief questions to determine whether further evaluation is warranted. Because women’s sexual desire encompasses biological, psychological, social, and contextual components, a biopsychosocial approach to evaluating and treating patients with HSDD is recommended. Although individualized treatment plan development for patients requires independent medical judgment, a simple algorithm can assist in the screening, diagnosis, and management of HSDD. Once a diagnosis of HSDD has been made, interventions can begin with office-based counseling and progress to psychotherapy and/or pharmacotherapy. Flibanserin, a postsynaptic 5-hydroxytryptamine 1A agonist and 2A antagonist that decreases serotonin levels and increases dopamine and norepinephrine levels, is indicated for acquired, generalized HSDD in premenopausal women and is the only agent approved in the United States for the treatment of HSDD in women. Other strategies to treat HSDD include using medications indicated for other conditions (eg, transdermal testosterone, bupropion). Bremelanotide, a melanocortin receptor agonist, is in late-stage clinical development. Conclusions Providers of gynecologic care are uniquely positioned to screen, counsel, and refer patients with HSDD. Options for pharmacotherapy of HSDD are currently limited to flibanserin, approved by the US Food and Drug Administration, and off-label use of other agents.
Introduction: Hypoactive sexual desire disorder (HSDD) often has a negative impact on the health and quality of life of women; however, many women do not mention—let alone discuss—this issue with their physicians. Providers of gynecologic services have the opportunity to address this subject with their patients. Aim: To review the diagnosis and evidence-based treatment of low sexual desire in women with a focus on strategies that can be used efficiently and effectively in the clinic. Methods: The Medline database was searched for clinically relevant publications on the diagnosis and management of HSDD. Results: HSDD screening can be accomplished during an office visit with a few brief questions to determine whether further evaluation is warranted. Because women’s sexual desire encompasses biological, psychological, social, and contextual components, a biopsychosocial approach to evaluating and treating patients with HSDD is recommended. Although individualized treatment plan development for patients requires independent medical judgment, a simple algorithm can assist in the screening, diagnosis, and management of HSDD. Once a diagnosis of HSDD has been made, interventions can begin with office-based counseling and progress to psychotherapy and/or pharmacotherapy. Flibanserin, a postsynaptic 5-hydroxytryptamine 1A agonist and 2A antagonist that decreases serotonin levels and increases dopamine and norepinephrine levels, is indicated for acquired, generalized HSDD in premenopausal women and is the only agent approved in the United States for the treatment of HSDD in women. Other strategies to treat HSDD include using medications indicated for other conditions (eg, transdermal testosterone, bupropion). Bremelanotide, a melanocortin receptor agonist, is in late-stage clinical development. Conclusions: Providers of gynecologic care are uniquely positioned to screen, counsel, and refer patients with HSDD. Options for pharmacotherapy of HSDD are currently limited to flibanserin, approved by the US Food and Drug Administration, and off-label use of other agents.Clayton AH, Kingsberg SA, Goldstein I. Evaluation and Management of Hypoactive Sexual Desire Disorder. Sex Med 2018;6:59–74. Key Words: Sexual Dysfunction, Hypoactive Sexual Desire Disorder, Flibanserin, Screening, Diagnosis, Drug Therapies
Author Clayton, Anita H.
Kingsberg, Sheryl A.
Goldstein, Irwin
AuthorAffiliation 3 Sexual Medicine, Alvarado Hospital, San Diego, CA, USA
1 Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
2 OB/GYN Behavioral Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA
AuthorAffiliation_xml – name: 1 Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
– name: 2 OB/GYN Behavioral Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA
– name: 3 Sexual Medicine, Alvarado Hospital, San Diego, CA, USA
Author_xml – sequence: 1
  givenname: Anita H.
  surname: Clayton
  fullname: Clayton, Anita H.
  email: ahc8v@virginia.edu
  organization: Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
– sequence: 2
  givenname: Sheryl A.
  surname: Kingsberg
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  organization: OB/GYN Behavioral Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA
– sequence: 3
  givenname: Irwin
  surname: Goldstein
  fullname: Goldstein, Irwin
  organization: Sexual Medicine, Alvarado Hospital, San Diego, CA, USA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/29523488$$D View this record in MEDLINE/PubMed
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Issue 2
Keywords Sexual Dysfunction
Screening
Hypoactive Sexual Desire Disorder
Diagnosis
Drug Therapies
Flibanserin
Language English
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Snippet Hypoactive sexual desire disorder (HSDD) often has a negative impact on the health and quality of life of women; however, many women do not mention—let alone...
Hypoactive sexual desire disorder (HSDD) often has a negative impact on the health and quality of life of women; however, many women do not mention-let alone...
Abstract Introduction Hypoactive sexual desire disorder (HSDD) often has a negative impact on the health and quality of life of women; however, many women do...
INTRODUCTIONHypoactive sexual desire disorder (HSDD) often has a negative impact on the health and quality of life of women; however, many women do not...
Introduction: Hypoactive sexual desire disorder (HSDD) often has a negative impact on the health and quality of life of women; however, many women do not...
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StartPage 59
SubjectTerms Diagnosis
Drug Therapies
Flibanserin
Hypoactive Sexual Desire Disorder
Review
Screening
Sexual Dysfunction
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Title Evaluation and Management of Hypoactive Sexual Desire Disorder
URI https://dx.doi.org/10.1016/j.esxm.2018.01.004
https://www.ncbi.nlm.nih.gov/pubmed/29523488
https://search.proquest.com/docview/2012911170
https://pubmed.ncbi.nlm.nih.gov/PMC5960024
https://doaj.org/article/b4eb7355732c4004b132026791dbf2d4
Volume 6
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