Abstract
Hypoactive sexual desire disorder (HSDD) is a persistent deficiency or absence of sexual fantasies and desire resulting in significant distress or interpersonal difficulty. Women with this disorder may display a lack of motivation for sexual activity, reduced responsiveness to erotic cues, a loss of interest during sexual activity, and avoidance of situations that could lead to sexual activity. The pathophysiology of HSDD is thought to be centered around inhibitory and excitatory hormones, neurotransmitters, and specific brain anatomy. Due to the multifactorial nature of HSDD, treatment can be complex and must attempt to target the biological and psychosocial aspects of the disorder. Bremelanotide is a melanocortin receptor agonist and has been recently approved by the FDA to treat HSDD. Bremelanotide is administered intranasally or as a subcutaneous injection. The recommended dosage of bremelanotide is 1.75 mg injected subcutaneously in the abdomen or thigh at least 45 min before sexual activity. Studies showed improvements in desire, arousal, and orgasm scores when 1.75 mg of bremelanotide was administered before sexual activity compared to a placebo. Bremelanotide is a promising way to treat HSDD.
Highlights
Hypoactive sexual desire disorder (HSDD) is the most prevalent female sexual health disorder [1]
The prevalence of low sexual desire has been reported to be similar among surgically postmenopausal women of European descent; HSDD was more prevalent in France (22%) than in Germany (7%), which suggests that culture plays a role in developing HSDD [15]
This study reports that this sexual desire brain network (SDBN) upholds the top-down processing model of HSDD, suggesting that women with
Summary
Hypoactive sexual desire disorder (HSDD) is the most prevalent female sexual health disorder [1]. The criteria based on the Diagnostic and Statistical manual are “persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity: that causes marked distress or interpersonal difficulty” [3]. Women with this disorder may display a lack of motivation for sexual activity, reduced responsiveness to erotic cues, a loss of interest during sexual activity, and avoidance of situations that could lead to sexual activity. Several factors have been proposed to explain the etiology of low sexual desire and the accompanying distress These factors include partners and life situation, ethnicity and culture, menopause status, central nervous system activity, and hormonal influences [10]. The current biological therapies for HSDD include flibanserin, testosterone therapy, bupropion (off-label treatment), and buspirone (off-label treatment) [2]
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