Management Of Hypoactive Sexual Desire Disorder Research Articles

Characteristics of systemic testosterone therapy for female hypoactive sexual desire disorder-a claims database analysis.

Testosterone therapy (TTh) is recommended for postmenopausal women with hypoactive sexual desire disorder (HSDD); however, there remain insufficient data to support use of TTh in premenopausal women with sexual dysfunction. In this study, we used a large national database to evaluate prescribing trends of TTh for women with HSDD. We conducted a cohort analysis of information from electronic health records acquired from the data network TriNetX Diamond. The study cohort consisted of women 18-70 years of age with a diagnosis of HSDD. We analyzed trends of testosterone prescriptions, routes of testosterone administration, and coadministration of testosterone with estrogen. Despite an increase in rates of testosterone prescriptions for HSDD, there remains a high degree of variability in the duration of treatment, route of administration, and coadministration of estrogen with significant underprescription of testosterone. Our query of the TriNetX database led to the identification of 33 418 women diagnosed with HSDD at a mean age of 44.2 ± 10.8years, among whom 850 (2.54%) women received a testosterone prescription. The testosterone prescriptions were highly variable with regard to duration and route of administration and coadministration with estrogen. For all patients until 2015, the prevalence of testosterone prescriptions for HSDD showed a positive quadratic relation was observed. Since 2015 a linear increase in prevalence was observed, with the highest rate of increase for patients aged 41-55years. The findings of this study reveal a significant need for further research investigating the optimal use of TTh to enhance the sexual health of women with HSDD, and further studies on the long-term effects of testosterone use must be undertaken to ensure that patients have access to safe and effective treatment. Limitations to this study include patient de-identification and lack of availability of testosterone dosage data. However, this study also has many strengths, including being the first, to our knowledge, to characterize the prescribing trends of testosterone for women with HSDD. Testosterone therapy should be considered as a potential therapy for premenopausal female patients with HSDD. Further studies on the long-term effects of testosterone use must be undertaken to address disparities in the management of HSDD and to ensure patients can access treatment.

Instruments for Screening, Diagnosis, and Management of Patients with Generalized Acquired Hypoactive Sexual Desire Disorder.

Screening, diagnosis, and management of hypoactive sexual desire disorder (HSDD) and research into the condition have been challenging due to its biopsychosocial complexity and lack of consensus on relevant measures. Although physician interviews yield much clinically valid information, self-reported questionnaires appear more acceptable to patients and physicians. Consequently, validated patient-reported outcome (PRO) tools are essential for evaluation and management of HSDD, including any therapeutic intervention. The US Food and Drug Administration (FDA) has issued guidance on the use of appropriate endpoints and associated measures for female sexual dysfunction, including HSDD. Although many of the available measures were not designed specifically for HSDD assessment, as per FDA guidelines, most clinical studies have used individual domains or items from established tools, such as the Female Sexual Function Index-desire domain and Item 13 of the revised Female Sexual Distress Scale. For clinical practice, several professional societies recommend the Decreased Sexual Desire Screener and/or a sexual history as tools to diagnose HSDD. This review discusses frequently used PRO tools as well as the newly developed and validated Elements of Desire Questionnaire, which may be appropriate for clinical trials or clinical practice.

Physician Attitudes Regarding Hypoactive Sexual Desire Disorder in a Primary Care Clinic: A Pilot Study

Female sexual dysfunction (FSD), in particular, complaints of low desire, affects many American women. Despite the impact FSD may have on these women, many do not present their symptoms to their physicians. To determine physician attitudes and practices regarding hypoactive sexual desire disorder (HSDD) in the primary care setting. A 10-item questionnaire regarding HSDD. All residents and faculty in an academic primary care clinic were invited to participate in a web-based survey regarding HSDD. Return of the questionnaire was considered consent. Responses were downloaded into Excel and converted into an spss database. In total, 53 of 155 physicians responded (46% response rate-41.5% women, 58.5% men). Of respondents, 90% reported little confidence in making the diagnosis of HSDD, 90% of physicians had not screened a patient for HSDD, and 98% of the physicians had not prescribed medication for patients with HSDD. No significant gender differences among physicians were identified, but faculty providers had more confidence in diagnosing and treating HSDD than resident physicians. These results indicate there is an opportunity to improve patient care and life satisfaction by offering physicians training on diagnosis and management of HSDD.