PND6 - Unmet Needs in the Management of Hypoactive Sexual Desire Disorder in Premenopausal Women

Abstract

To gain insight into the diagnosis and management of hypoactive sexual desire disorder (HSDD) among premenopausal women reporting a diagnosis or symptoms of HSDD. A 30-minute, IRB-approved survey was designed to explore the patient experience and physical, social, mental, emotional, and economic burden related to HSDD. Inclusion criteria were ≥18 years of age, a diagnosis or symptoms of HSDD in accordance with the Decreased Sexual Desire Screener, currently in a stable, monogamous relationship with a partner for ≥6 months. Women with a bilateral oophorectomy or hysterectomy were excluded. 314 premenopausal women were included in the analysis. HSDD was most commonly managed by OB/GYNs (47.8%) or PCPs (35.5%). Among respondents who discussed their HSDD symptoms with their physician/therapist (n=203), 82.3% initiated the conversation themselves. While respondents generally had a positive perception of their physicians/therapists, 24.4% of respondents believed their HCPs were not aware of HSDD as a medical condition, and 16.7% of respondents felt their HCP did not take their concerns seriously. The most commonly prescribed treatments, lubricants (51.6%) and meditation/yoga (36.6%), were nonpharmacologic, which have no documented efficacy. Antidepressants or anti-anxiety medications were prescribed to 14.6% of respondents. Respondents who received nonpharmacologic treatments (n=243) generally found treatments safe but 35.8% cited poor efficacy; common reasons for ineffectiveness included no change in interest in sexual activity (65.8%) and inability to “stay in the moment” during sexual activity (57.6%). Although HSDD is recognized as a medical condition by ISSWSH (consensus review) and the APA (DSM-IV-TR), diagnosis and treatment are largely patient-initiated rather than HCP-driven. There is a need for improved HCP education, as many lack knowledge of how to diagnose and treat HSDD. Prescription patterns, which tend toward nonpharmacologic treatments, also suggest a lack of understanding of disease etiology and/or a paucity of approved and efficacious treatment options.