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The causes and prevalence of hypoactive sexual desire disorder: part I
Abstract
Hypoactive sexual desire disorder (HSDD) is the most common complaint among women experiencing sexual dysfunction. The cause of HSDD is often multifactorial, and there are no treatments approved by the Food and Drug Administration available to women at this time.
... Another major reason that potentiates the risk of sexual impairment is social, cultural risk factor which consists of financial issues, limited social relations, employment status and lack of exercise [32]. Apart from this, there are other factors that contribute to the development of sexual dysfunction such as aging, [33] cardiovascular diseases, [34] Hypertension, [35] genitourinary disease [36] and many more chronic diseases . Diabetes mellitus itself is responsible for the high incidence of sexual problems. ...
... It is evident from several research studies that an imbalance of hormones such as androgens, estrogens and sex hormone binding globulin greatly affects sexual arousal [36]. However, it can be improved by taking hormone replacement therapy, which is the only best possible treatment currently approved by certain organizations. ...
Diabetes would not just have a high blood glucose level in the individual body, yet these days diabetes likewise goes with numerous other organic issues like hypertension, feeble the myocardial layer working, sexual broke, and so on. These are some real issue which is these days joined by diabetes to a person’s body. Guys are for the most part being determined to have the sexual broke issue, guys, as well as experience a sexual broke issue. As similarly we may see less clinical examinations, including sexual broke issues looked for the sort two diabetic ladies. The primary goal of this article is to illuminate the situation that females proceed with much trouble with regards to the sexual broke Complication that might be physiological or neurotic if there should arise an occurrence of sorting two diabetes in ladies. It chiefly involves the useful extent of females like sexual drive, excitement, vaginal grease, Orgasm and general fulfilment space. Talking about the treatmentaccess of the ailment in the analyti way for it, Diabetes essentially hinders the sexual execution of Diabetic Women. Determinants of sexual ability incorporate age and extent of diabetes.
... It has also been suggested that hormonal imbalance, which accompanies diabetes, plays a role in the pathogenesis of the female sexual function. Epidemiological studies conducted among diabetic women have shown changes in the levels of estrogens, androgens, and sex hormone-binding globulin (SHBG) to be correlated with sexual arousal and desire complications in these women (Feldhaus-Dahir, 2009). ...
Medical conditions could partly underlie sexual dysfunction among post-menopausal women. The aim of this study was to determine the relationship between medical conditions and sexual function in post-menopausal women. This is a cross-sectional study of 405 post-menopausal women. A multistage random sampling was initially carried out. The data was collected through interviews using the Female Sexual Function Index (FSFI) questionnaire and a self-administered questionnaire, and was analyzed using the chi-square test, the t-test and multiple linear regression. The results showed that sexual dysfunction was more prevalent among the participants with medical conditions (p = 0.037). Scores of arousal (p = 0.000), orgasm (p = 0.018), and satisfaction (p = 0.026), along with the FSFI total scores (p = 0.005), were significantly lower in the participants suffering from cardiovascular disorders. Scores of desire (p = 0.001), arousal (p = 0.006), lubrication (p = 0.010), orgasm (p = 0.004), and satisfaction (p = 0.022), as well as the FSFI total scores (p = 0.017), were significantly lower among the participants with diabetes. Scores in the pain domain were significantly lower among those with musculoskeletal disorders (p = 0.041). We conclude that cardiovascular disorders, diabetes, and musculoskeletal disorders could have a negative impact on the sexual function of post-menopausal women. Therefore, these conditions need to be taken into consideration in order to improve these women’s sexual function.
... Hormonal imbalance regarding androgens, estrogens, and sex-hormone binding globulin [22] is a likely culprit for arousal disorder, which is defined by the lack of vasodilation and engorgement in the female external genetalia, namely the clitoris and vagina [23]. Diabetic neuropathy may be implicated in decreased innervation to the clitoris and vagina for blood flow, generating diffuse fibrosis of the clitoris and vaginal tissues, and thinning the musculature and epithelium of the vagina [12,24,25]. ...
Diabetes mellitus, when producing hyperglycemia, as well as angiopathic, vasculopathic, and neuropathic complications, poses a threat to the function and viability of sexual arousal and intercourse at similar and different levels in males and females. Males are faced with hypogonadism, depression and anxiety, affecting their sexual arousal desire. Male intercourse may be impaired by erectile dysfunction, priapism, ejaculatory dysfunction ,and/or benign prostatic hyperplasia. Female sexual arousal may be affected by depression, hormonal imbalance, and hypoactive sexual desire disorder. Female sexual intercourse may be disturbed by dyspareunia, vaginismus, and anorgasmia. Effects on sexual intercourse may also be seen at the gender neutral level due to cranial neuropathy and various autonomic neuropathies outside the genitourinary tract. Though specific treatments target most conditions, healthy diet and exercise are the best bets to avoid the long-term effects of diabetic complications on sexuality.
... Dyspareunia should be further classified as insertional or penetrational (upon deep penetration by the partner), as the former is more common with vestibular or dermatologic disorders, whereas the latter is often due to pelvic floor or postsurgical conditions [9]. A thorough review of medications should be performed, as this is one of the most common causes of secondary HSDD [10]. A full list of causes of acquired HSDD is listed in Table 1. ...
Complaints of decreasing sexual desire in women are common. Hypoactive Sexual Desire Disorder (HSDD) is defined as the loss of sexual desire, not attributable to any other medical cause, which results in marked personal distress and is the most frequently diagnosed female sexual dysfunction. Because urologists treat women for a variety of pelvic and vaginal disorders they should feel comfortable discussing female sexual issues and take the important opportunity to help women with HSDD. Taking a good sexual history and performing a proper exam are of utmost importance when evaluating women with low sexual desire. Unfortunately there is a paucity of literature within the urologic community on this topic*likely due to a lack of awareness among physicians. Herein we review the literature of the past decade on HSDD and provide the practitioner with the basic information needed to diagnose and treat HSDD. We discuss the use of testosterone as well as potential new therapies that are currently in development. Despite the prevalence of this distressing disease, there remains a lack of widely available and accepted treatments. Nevertheless, by better understanding HSDD, urologists can play a vital role in improving the sexual health of women with female sexual dysfunction.
... 124,125 It has been hypothesized that FSD may be the consequence of an imbalance in the hormonal levels of diabetic women, as indicated by epidemiological studies showing a correlation between alterations in the levels of androgens, estrogens, as well as sex hormone-binding globulin and sexual problems in diabetic women. 126 ...
Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It has been associated with sexual dysfunction, both in males and in females. Diabetes is an established risk factor for sexual dysfunction in men, as a threefold increased risk of erectile dysfunction was documented in diabetic men, as compared with nondiabetic men. Among women, evidence regarding the association between diabetes and sexual dysfunction are less conclusive, although most studies have reported a higher prevalence of female sexual dysfunction in diabetic women as compared with nondiabetic women. Female sexual function appears to be more related to social and psychological components than to the physiological consequence of diabetes. Hyperglycemia, which is a main determinant of vascular and microvascular diabetic complications, may participate in the pathogenetic mechanisms of sexual dysfunction in diabetes. Moreover, diabetic people may present several clinical conditions, including hypertension, overweight and obesity, metabolic syndrome, cigarette smoking, and atherogenic dyslipidemia, which are themselves risk factors for sexual dysfunction, both in men and in women. The adoption of healthy lifestyles may reduce insulin resistance, endothelial dysfunction, and oxidative stress - all of which are desirable achievements in diabetic patients. Improved well-being may further contribute to reduce and prevent sexual dysfunction in both sexes.
The issue of sexual dysfunction in diabetes is not limited to purveying prescriptions for drugs that are of help in this situation. Sex is one of the deepest drives of human existence and has many layers and concerns which need a much deeper understanding of this issue, much of which is beyond prescription. The understanding of nondrug issues is also essential to deal with those not infrequent unsatisfactory results after drug treatment. The need for a humanistic, emphatic, and supportive understanding to develop in dealing with female sexuality is profound and deeply rooted in the psyche developed over millions of generations. To cause a change is necessary in today’s times which incidentally will lead to an equally profound change in the treating physicians themselves. This chapter may be read from this perspective.
Male hypoactive sexual desire disorder (HSDD) was first introduced as inhibited sexual desire in 1970. Today’s researchers continue to explore the cause of onset, and forms of treatment to expand the understanding of HSDD. Researchers have identified multiple factors that contribute to its development, such as medical and psychological comorbid conditions, biological, or physiological changes, as well as psychological, social, and developmental factors. The wide variety of causes lead to a series of treatment options. These include couples and/or sex therapy, prescribed testosterone, and lifestyle changes. Even with recent advances, this field has yet to standardize treatments based on best evidence.
Background: Sexual dysfunction could be under the influence of some underlying medical problems. The purpose of this study is to examine the relationship between medical problems and sexual function in post-menopausal women. Methods: This is a community-based, descriptive-correlation study of 405 postmenopausal women residing in Chalus and Nowshahr cities, North of Iran, aged 40 to 65 years old from October 2013 to May 2014. A multistage, randomized sampling was conducted. The data was acquired through interviews using the Female Sexual Function Index (FSFI) questionnaire and a researcher-made questionnaire, and was analyzed using descriptive and analytical tests such as multiple linear regression and logistic regression models. Results: 51.4% of the subjects had medical conditions. Cardiovascular disorders were the most common diseases among the subjects. 61% of the women were suffering from female sexual dysfunction (FSD). Sexual dysfunction in patients with medical conditions was significantly higher (P= 0.037). Scores of arousal (P= 0.000), orgasm (P= 0.018), and satisfaction (P= 0.026), as well as the FSFI total score (P= 0.005), were significantly lower in subjects with cardiovascular disorders. Scores of desire (P= 0.001), arousal (P= 0.006), lubrication (P= 0.010), orgasm (P= 0.004), and satisfaction (P= 0.022), as well as the FSFI total score (P= 0.017), were significantly lower in subjects with diabetes. Scores of pain were significantly lower in subjects with musculoskeletal disorders (P= 0.041), they experienced more pain during intercourse. In domains of arousal (P= 0.030), satisfaction (P= 0.040), and pain (P= 0.044), the scores of those taking antihypertensive medications were significantly lower than the scores of the rest of the subjects. Scores of desire (P= 0.001), arousal (P= 0.006), orgasm (P= 0.006), and satisfaction (P= 0.048), as well as the FSFI total score (P= 0.006), were significantly lower in those taking antidiabetic drugs. And lastly, the mean satisfaction score in women whose spouse had medical conditions was significantly lower (P= 0.040). Conclusion: Cardiovascular disorders, diabetes, and musculoskeletal disorders could have a negative impact on sexual function in post-menopausal women. Thus, these diseases must be considered and treated in order to improve women’s health, particularly their sexual function. © 2016, Tehran University of Medical Sciences. All rights reserved.
Asexuality is an identity held by individuals who have low to no sexual desire or drive which can often be mistaken for hypoactive sexual desire disorder. This article highlights the key diagnostic and clinical differences between hypoactive sexual desire disorder and asexuality. It provides key information about the various typologies of asexuality. We describe the 4 phases of treatment: joining, clarifying definitions, challenging beliefs, and assumptions of socially sanctioned behavior, and developing a common or agreed-upon definition of expression. A case vignette is included.
The following literature review will focus on sexual dysfunction in women living with diabetes, drawing on international studies in this specialist field. The key aim of this paper is generate a greater understanding and recognition of the issues facing these women and to determine a more proactive approach to identification, consultation and potential treatment options. The main findings highlight the unique role practitioners have with women with diabetes and how to facilitate partnership working. Nurses have the most frequent contact with people living with diabetes in any healthcare system. Nurses' knowledge about sexuality in relation to diabetes should improve patient education, recognition and could signal undiagnosed or increased risk of sexual dysfunction to enable treatment so care can be optimised accordingly (Sivrikaya et al., 2014).
Copyright © 2015. Published by Elsevier Inc.
The hypoactive sexual desire is a frequent sexual disorder, especially in women, and presents diagnostic and therapeutic difficulties. In general, doctors do not know how to manage a patient who suffers this problem. In the present article there is a revision of essential aspects of the sexual desire and the factors related to its loss proposing a method of clinical intervention that allows to the doctor to act in a sensible way in a case of hypoactive sexual desire. Finally, there is a revision of some of the drug therapies used up to this moment to treat the disorder.
Hypoactive sexual desire disorder (HSDD) affects nearly 1 in 10 women. Thus, it is essential for pharmacists and other health care providers to be comfortable when discussing a patient's sexual health to ensure appropriate triage so that the specific causes of HSDD can be identified and potential recommendations provided. HSDD is defined as the absence or deficiency of sexual interest and/or desire, leading to significant distress and interpersonal difficulties. As health care providers, pharmacists have a critical role in assessing the presence of HSDD and providing education on available treatment options. This article will review the potential causes of HSDD and low sexual desire, the screening tools available, and the significant role of health care professionals in communicating with patients about their sexual health. An overview of the importance of behavioral modifications, the current pharmacologic options being investigated, and the use of complementary and alternative therapies will also be explored. Currently, buproprion is the primary pharmacologic agent that has shown positive results in treating patients with HSDD. The use of testosterone therapy will not be addressed in this article, as this therapy is described in greater detail elsewhere.
There is increasing awareness of the significant and varied actions of endogenous androgens in women, and acknowledgement that women might experience symptoms secondary to androgen deficiency. There is also substantial evidence that prudent testosterone replacement is effective in relieving both the physical and psychological symptoms of androgen insufficiency in clinically affected women. However, our understanding of the actions of testosterone in women is incomplete, with no consensus as to what constitutes either biochemical or clinical testosterone deficiency. The focus of the limited research into testosterone replacement has been on sexuality, primarily sexual desire. However, the influence of testosterone on mood and well being also requires further exploration.