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Anita H Clayton, Irwin Goldstein, Noel N Kim, Stanley E Althof, Stephanie S Faubion, Brooke M Faught, Sharon J Parish, James A Simon, Linda Vignozzi, Kristin Christiansen, Susan R Davis, Murray A Freedman, Sheryl A Kingsberg, Paraskevi-Sofia Kirana, Lisa Larkin, Marita McCabe, Richard Sadovsky
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...
March 9, 2018: Mayo Clinic Proceedings
Anita H Clayton, Sheryl A Kingsberg, Irwin Goldstein
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...
March 6, 2018: Sexual Medicine
James A Simon, Leonard Derogatis, David Portman, Louise Brown, James Yuan, Robert Kissling
BACKGROUND: To evaluate the safety of flibanserin in premenopausal and naturally postmenopausal women with hypoactive sexual desire disorder (HSDD) in an open-label extension (OLE) study. AIM: To examine the safety and tolerability of flibanserin 100 mg once daily at bedtime in the treatment of premenopausal and naturally postmenopausal women with HSDD in a multicenter 28-week OLE study. METHODS: Patients entering this study received flibanserin or placebo in the double-blinded, placebo-controlled trials of premenopausal and postmenopausal women and in a pharmacokinetic study of postmenopausal women...
March 2018: Journal of Sexual Medicine
Ho Ju Yun, Hyun Hee Cho
This cross-sectional study analysed the characteristics of HSDD (hypoactive sexual desire disorder) in Korean women. Two hundred and seventeen women seen for sexual dysfunction were assessed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Revised (DMS IV-TR) and the Female Sexual Function Index (FSFI). A diagnosis of HSDD was more common in women in their 40 s (56%), who had previously undergone surgery for a feeling of 'wide vagina'. Both too much or too little sexual activity caused HSDD...
February 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Ryan Anderson, Claire E Moffatt
BACKGROUND: Female sexual dysfunction (FSD) affects as many as 1 in every 3 women, with a significant portion of these with hypoactive sexual desire disorder (HSDD). These figures alone present significant psychological and pharmacologic challenges. Partly in response to this situation, in 2015 the US Food and Drug Administration approved flibanserin for the treatment of HSDD. This approval has drawn criticism on the grounds of efficacy and necessity. AIM: To better inform potential consumers about FSD, flibanserin and other interventions for the treatment of HSDD, the importance of understanding the mechanism of FSD, and the efficacy of flibanserin and to review existing relevant knowledge...
January 27, 2018: Journal of Sexual Medicine
A Pitiot, J K Smith, D J Humes, J Garratt, S T Francis, P A Gowland, R C Spiller, L Marciani
BACKGROUND: Recent studies have shown that the brain of patients with gastrointestinal disease differ both structurally and functionally from that of controls. Highly somatizing diverticular disease (HSDD) patients were also shown to differ from low somatizing (LSDD) patients functionally. This study aimed to investigate how they differed structurally. METHODS: Four diseases subgroups were studied in a cross-sectional design: 20 patients with asymptomatic diverticular disease (ADD), 18 LSDD, 16 HSDD, and 18 with irritable bowel syndrome...
February 2, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Robert E Pyke, Anita H Clayton
BACKGROUND: The Female Sexual Function Index-desire subscale is the standard measure for clinical trials of hypoactive sexual desire disorder (HSDD), but lacks items assessing sexually related behaviors and attitudes toward partner. Counting satisfying sexual events is criticized, but sexual behavior remains important. Mean treatment differences cannot define clinical significance; responder and remitter analyses help. We reviewed measures on sexual desire and sexual behavior relevant to HSDD, and how to assess clinical significance...
January 19, 2018: Sexual Medicine Reviews
Ahmed AlAwlaqi, Houda Amor, Mohamed E Hammadeh
Over the decades, female sexual dysfunction (FSD) has grown to be an increasingly potential problem that complicates the quality of life among women. In the current review, FSD refers to recurrent and persistent problems with sexual orgasm, desire, or response. One of the most common subtypes of FSD that has evoked increased research interest in the scientific community is hyposexuality. Today, there is a consensus that hyposexuality is a multifactorial condition that manifests with reduced sexual desire resulting in significant interpersonal distress...
December 15, 2017: Journal of the Turkish German Gynecological Association
Harry A Croft
BACKGROUND: The neurobiology of sexual response is driven in part by dopamine and serotonin-the former modulating excitatory pathways and the latter regulating inhibitory pathways. Neurobiological underpinnings of hypoactive sexual desire disorder (HSDD) are seemingly related to overactive serotonin activity that results in underactive dopamine activity. As such, pharmacologic agents that decrease serotonin, increase dopamine, or some combination thereof, have therapeutic potential for HSDD...
December 2017: Journal of Sexual Medicine
Fabiene Bernardes Castro Vale, Karla Zanolla Dias de Souza, Camilla Russi Rezende, Selmo Geber
Although hypoactive sexual desire disorder (HSDD) is the most common sexual complaint, there is no consensus for the ideal treatment. Our study aimed to evaluate the efficacy of treating premenopausal women with HSDD with Tribulus terrestris and its effect on the serum levels of testosterone. We performed a prospective, randomized, double-blind, placebo-controlled trial, with 40 premenopausal women reporting diminished libido, receiving T. terrestris or placebo. The questionnaires FSFI and the QS-F were used to evaluate sexual dysfunction before and after treatment...
November 27, 2017: Gynecological Endocrinology
Julia I O'Loughlin, Rosemary Basson, Lori A Brotto
In 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published with a major revision to the sexual dysfunction categories, and the diagnosis of female hypoactive sexual desire disorder (HSDD) was replaced with female sexual interest/arousal disorder (SIAD). Since being introduced, concern has been expressed that SIAD inappropriately "raises the bar" for diagnosis. To address these concerns, we sought to evaluate the number of women with a diagnosis of HSDD who also met criteria for SIAD...
November 2, 2017: Journal of Sex Research
Nicole M Lodise
Flibanserin is the first US Food and Drug Administration (FDA)-approved option for sexual dysfunction, specifically low sexual desire. Until recently, there were no FDA-approved medication options to assist the ~40% of women affected by female sexual dysfunction (FSD). Often, patients report feeling uncomfortable discussing sexual health, identifying a strong need for health care professionals (HCPs) to proactively reach out to patients to identify concerns and initiate a discussion about sexual health and the available treatment options...
2017: International Journal of Women's Health
Penelope J Robinson, Robin J Bell, Marie K Christakis, Stephanie R Ivezic, Susan R Davis
BACKGROUND: Little is known of the impact of aromatase inhibitor (AI) therapy on sexual and pelvic floor function. AIM: To document the prevalence of, and factors associated with, low desire, sexually related personal distress, hypoactive sexual desire dysfunction (HSDD), and pelvic floor dysfunction in women 10 years after breast cancer diagnosis. METHODS: This was a prospective, observational, community-based cohort study of Australian women with invasive breast cancer recruited within 12 months of diagnosis...
December 2017: Journal of Sexual Medicine
Yvonne van Nes, Jos Bloemers, Peter G M van der Heijden, Kim van Rooij, Jeroen Gerritsen, Rob Kessels, Leonard DeRogatis, Adriaan Tuiten
BACKGROUND: The efficacy of on-demand drugs for hypoactive sexual desire disorder (HSDD) or female sexual interest/arousal disorder (FSIAD) should be assessed using a validated instrument that assesses the discrete sexual events during which the on-demand drug is taken. AIM: To develop and validate an event log for measuring sexual satisfaction and sexual functioning of discrete sexual events. METHODS: Psychometric assessment was carried out on data of 10,959 Sexual Event Diaries (SEDs) collected during three clinical trials in a total of 421 women with HSDD...
November 2017: Journal of Sexual Medicine
Susanna B Hummel, Daniela E E Hahn, Jacques J D M van Lankveld, Hester S A Oldenburg, Eva Broomans, Neil K Aaronson
BACKGROUND: Many women develop sexual problems after breast cancer (BC) treatment. Little is known about BC survivors with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) sexual dysfunction and their partners, and the factors associated with their sexual functioning. AIM: To evaluate (i) patient-related and clinical factors associated with (a) specific DSM-IV sexual dysfunctions and (b) level of sexual functioning and sexual distress as reported by BC survivors and (ii) the association between the sexual functioning of BC survivors and that of their partners...
October 2017: Journal of Sexual Medicine
Charmaine Rochester-Eyeguokan, Lisa Meade
Female sexual dysfunction (FSD) is highly prevalent in women with diabetes mellitus (DM), yet it remains unaddressed, undiagnosed, and untreated. Hypoactive sexual desire disorder (HSDD) is the most common complaint among women with FSD, but there is a paucity of research into its multifactorial etiology. Flibanserin is the only therapy approved by the US Food and Drug Administration for treating acquired, generalized HSDD in premenopausal women. Women with DM diagnosed with HSDD may require a multidisciplinary approach for optimal management...
October 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Stephanie Cacioppo
INTRODUCTION: Recent advances in neuroimaging offer an unprecedented window into the female sexual brain. The small samples and poor statistical power of individual functional magnetic resonance imaging studies have limited what can be gleaned about the systematic brain network that is involved in female sexual desire and female sexual dysfunction (eg, hypoactive sexual desire disorder [HSDD]). AIM: To quantitatively determine the brain network involved in HSDD...
August 30, 2017: Sexual Medicine Reviews
Susan G Kornstein, James A Simon, Stuart C Apfel, James Yuan, Krista A Barbour, Robert Kissling
BACKGROUND: Flibanserin, a 5-HT1A agonist and 5-HT2A antagonist, is indicated for the treatment of acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. This post hoc analysis evaluated the effect of flibanserin treatment on body weight in premenopausal and postmenopausal women with HSDD. MATERIALS AND METHODS: This analysis included three 24-week, double-blind, placebo-controlled studies of flibanserin 100 mg each bedtime (qhs) in premenopausal women, a similarly designed study in postmenopausal women, and a 52-week, open-label extension study in premenopausal women...
November 2017: Journal of Women's Health
Nicholas Granzella, Betty C Chen, Geoffrey S Baird, Matthew Valento
INTRODUCTION: Flibanserin is a medication recently approved by the FDA for treatment of generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. Its mechanism of action is not fully understood but is thought to modulate serotonin receptors and increase levels of norepinephrine and dopamine. While much is known about toxicity of other drugs which affect these systems, there is little information about toxicity of flibanserin at this time. CASE: We present a case of a 2-year-old boy who ingested an estimated 600 mg of his mother's flibanserin...
August 17, 2017: Clinical Toxicology
D M Stevens, J M Weems, L Brown, K A Barbour, S M Stahl
WHAT IS KNOWN AND OBJECTIVE: Flibanserin is a serotonin 5-HT1A agonist and 5-HT2A antagonist approved for the treatment of acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. Because of the increased risk of hypotension- and syncope-related adverse events (AEs) observed with coadministration of flibanserin and alcohol, alcohol use is contraindicated. To provide a more comprehensive understanding of the interaction between flibanserin and alcohol, the results of a dedicated phase 1 alcohol-interaction study and a pooled analysis of phase 3 studies of premenopausal women with HSDD are presented...
June 13, 2017: Journal of Clinical Pharmacy and Therapeutics
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