Providers of gynecologic services have the opportunity to address this subject with their patients. To review the Situational hypoactive sexual desire 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.
Although individualized treatment plan development for patients requires independent medical judgment, a simple algorithm can assist in Situational hypoactive sexual desire screening, diagnosis, and management of HSDD. 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.
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. Hypoactive sexual desire disorder HSDD is defined as a persistent or recurrent deficiency or absence of sexual fantasies and desire for sexual activity that causes marked distress or interpersonal difficulty not related to a medical or psychiatric condition or the use of a substance or medication.
Situational hypoactive sexual desire discussion of the literature on diagnosis and evidence-based treatment of low sexual desire in women focuses on strategies that can be used efficiently and effectively in the clinic. Distressing low sexual desire can be attributed to a number of biological, psychological, social, and contextual components.
These include psychological factors, such as boredom, situational stress, self-consciousness about body image, and distraction; and social and contextual factors that include cultural norms, familial teachings, and relationship considerations. The neurochemical basis of HSDD has not been fully elucidated; however, it is currently understood that low sexual desire results from hypofunctional excitation, hyperfunctional inhibition, or a combination of the 2. The central features of HSDD are low sexual desire and associated distress.
The pattern is persistent or recurrent over a period of at least several months and occurs frequently, though may fluctuate in severity, and is not secondary "Situational hypoactive sexual desire" a sexual pain disorder. The symptoms are associated with clinically significant distress.
Although the symptoms of HSDD have been clearly defined, 1 recognizing low sexual desire or distressing sexual problems is complicated by the fact that women often do not spontaneously mention these issues to their health care providers.
Situational hypoactive sexual desire of this, it is incumbent on providers of gynecologic services to broach the subject with their patients. Screening for HSDD can be accomplished in a time-efficient manner during an office visit.
A few brief questions could determine whether further evaluation is warranted. For example, are you sexually active? If not, why not? What sexual concerns do you have? How do you feel about your level of sexual desire, arousal, or orgasm?
To facilitate these discussions, ensure a safe, non-judgmental environment for the patient. If screening suggests the presence of HSDD, the next steps should include soliciting more detailed information from patients about their experience of low desire, including onset, duration, behavioral adaptation and avoidance, and level of distress.