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Desire Disorder (desire + disorder)

Distribution by Scientific Domains
Medical Sciences100%

Kinds of Desire Disorder

  • hypoactive sexual desire disorder
    		•
  • sexual desire disorder
    		•

    Selected Abstracts

    ORIGINAL RESEARCH,OUTCOMES ASSESSMENT: Validation of the Female Sexual Distress Scale-Revised for Assessing Distress in Women with Hypoactive Sexual Desire Disorder

    THE JOURNAL OF SEXUAL MEDICINE, Issue 2 2008
    Leonard DeRogatis PhD
    ABSTRACT Introduction., The concept of sexually related personal distress is currently central to the diagnosis of all female sexual dysfunctions (FSD). In the current study, we have focused on validating a slightly revised version of the Female Sexual Distress Scale (FSDS), the FSDS-Revised (FSDS-R), to enhance the sensitivity of the instrument with patients suffering from hypoactive sexual desire disorder (HSDD). In addition, we have attempted to extend the validation generalizability of the scale by demonstrating that both instruments possess reliability and discriminative validity in premenopausal women with HSDD. Aim., To assess the validity of the revised version of the FSDS, the FSDS-R, for measuring sexual distress in women with HSDD. Methods., A prospective methodological study carried out at 27 centers in North America enrolled 296 women aged 18,50 years with HSDD, another female sexual dysfunction (FSD), or no FSD. The subjects completed the FSDS-R at baseline, day 7, and day 28, with a 30-day recall at baseline and with a 7-day recall on days 7 and 28. Main Outcome Measures., Receiver operating characteristic (ROC) analyses of FSDS, FSDS-R, and FSDS-R item 13 were used for the differentiation of HSDD from no FSD, while intraclass correlation coefficient (ICC) was used to estimate test,retest reliability. Cronbach's coefficient alpha was used to measure the internal consistency of the FSDS-R and Pearson's correlation coefficient to assess FSDS, FSDS-R, and FSDS-R item 13 with different recall periods (7 and 30 days). Results., Mean total FSDS, FSDS-R, and FSDS-R item 13 scores with either recall period were significantly higher (P < 0.0001) in women with FSD or HSDD than in women with no FSD, showing both tests had discriminant validity. ROC analysis confirmed these findings, while an ICC of >0.74 showed the test,retest reliability of both scales, including FSDS-R item 13 alone, and Cronbach's coefficient alpha of >0.86 confirmed the internal consistency of both tests. Conclusions., Consistent with the FSDS, the FSDS-R demonstrated good discriminant validity, high test,retest reliability, and a high degree of internal consistency in measuring sexually related personal distress in women with HSDD. FSDS-R item 13 alone also demonstrated good discriminant validity and test,retest reliability. DeRogatis L, Clayton A, Lewis-D'Agostino D, Wunderlich G, and Fu Y. Validation of the female sexual distress scale revised for assessing distress in women with hypoactive sexual desire disorder. J Sex Med 2008;5:357,364. [source]

    Methods to Determine the Minimum Important Difference for a Sexual Event Diary Used by Postmenopausal Women with Hypoactive Sexual Desire Disorder

    THE JOURNAL OF SEXUAL MEDICINE, Issue 5 2007
    Tara Symonds PhD
    ABSTRACT Introduction., Recently, there has been much discussion in the literature about how to determine the meaningfulness of results generated from a patient-reported outcome measure. A number of reviews have shown that there are two main approaches: anchor- and distribution-based approaches for determining the minimum important difference (MID) for a new measure. There are issues with calculating an MID using each method: Will the two approaches give the same estimate? If the estimates differ, how do you decide on one estimate? Would asking patients directly be more beneficial? Aim., A case study was presented to address these issues based on a newly developed diary assessing number of satisfactory sexual events (SSEs) per week in women with hypoactive sexual desire disorder (HSDD). Methods., Anchor- and distribution-based estimates were generated from data gathered in two double-blind, placebo-controlled, parallel group trials for the treatment of HSDD (N = 788). A novel interview study was used to ask women directly about an MID for SSEs (N = 77). Main Outcome Measures., Defining the MID for an SSE diary in women with HSDD. Results., The estimates varied, producing a range of mean MID estimates between 0.04 and 0.46 SSEs per week. Conclusion., We recommend that rather than defining the MID, a range should be selected from the set of estimates formed by the limits of the 95% confidence intervals. Symonds T, Spino C, Sisson M, Soni P, Martin M, Gunter L, and Patrick DL. Methods to determine the minimum important difference for a sexual event diary used by postmenopausal women with hypoactive sexual desire disorder. J Sex Med 2007;4;1328,1335. [source]

    ORIGINAL RESEARCH,ENDOCRINOLOGY: Transdermal Testosterone Gel prn Application for Hypoactive Sexual Desire Disorder in Premenopausal Women: A Controlled Pilot Study of the Effects on the Arizona Sexual Experiences Scale for Females and Sexual Function Questionnaire

    THE JOURNAL OF SEXUAL MEDICINE, Issue 1 2007
    Bella Chudakov MD
    ABSTRACT Introduction., Several studies suggest that increased plasma testosterone can improve sexual function and desire in post-oophorectomy or postmenopausal women. However, side effects of chronic daily testosterone raise questions about the generalizability of this treatment approach. Sublingual testosterone was reported to cause testosterone levels to peak after 15 minutes and then decline to baseline levels within 90 minutes. Three to 4 hours after reaching testosterone peak, increased genital sensations and sexual lust were reported. Aim., We hypothesized that a singe dose of testosterone given 4,8 hours prior to planned intercourse in women with hypoactive sexual desire disorder (HSDD) might increase desire without side effects associated with chronic use. Methods., The design was randomized double-blind crossover. Premenstrual women with HSDD received eight packets of gel or identical placebo for use before intercourse twice weekly for 1 month. For a second month, the alternate treatment was given. Main Outcome Measures., Ratings were performed using the patient-rated Arizona Sexual Experiences Scale for females and the clinician-rated Sexual Function Questionnaire (SFQ-V1). Results., Ten patients completed the study. On the five-item self-report Arizona, the item "How easily are you aroused?" was significantly improved on testosterone gel vs. placebo, P = 0.03. There were similar trends on the physician-rated SFQ-V1 "arousal,sensation" cluster. Conclusions., These preliminary results suggest that testosterone gel given prn before intercourse has effects on sexual arousal, and further research is needed to define dosage and time schedule to optimize this effect and determine its clinical relevance. Chudakov B, Ben Zion IZ, and Belmaker RH. Transdermal testosterone gel prn application for hypoactive sexual desire disorder in premenopausal women: A controlled pilot study of the effects on the Arizona Sexual Experiences Scale for females and Sexual Function Questionnaire. J Sex Med 2007;4:204,208. [source]

    ORIGINAL RESEARCH,WOMEN'S SEXUAL HEALTH: Comparison of Androgens in Women with Hypoactive Sexual Desire Disorder: Those on Combined Oral Contraceptives (COCs) vs.

    THE JOURNAL OF SEXUAL MEDICINE, Issue 5 2006
    Those not on COCs
    ABSTRACT Introduction., Approximately one out of four sexually active women in the United States uses some form of hormonal contraceptive method because they provide the most effective reversible method of birth control available. However, little attention has been paid to possible adverse effects of combined oral contraceptives (COCs) on sexual functioning. Aims., The aim of this study was to examine the potential effects of COCs on women with hypoactive sexual desire disorder (HSDD). It was hypothesized that female patients with generalized, acquired HSDD on COCs have lower androgen levels than those not on COCs. Methods., The patients were healthy premenopausal women with HSDD, aged 22,50 years. Subjects had a history of adequate sexual desire, interest, and functioning. Participants were required to be in a stable, monogamous, heterosexual relationship and were screened for any medication or medical or psychiatric disorders that impact desire. The patients met operational criteria for global, acquired HSDD. The 106 patients were divided into two groups: those on COCs (N = 43) and those not on COCs (N = 63). A two-tailed t -test comparison was made between the two groups comparing free and total testosterone and sex hormone-binding globulin (SHBG). Main Outcome Measures., The main outcome measures are the differences between the two groups comparing free testosterone, total testosterone, and SHBG. Results., These patients with HSDD on COCs had significantly lower free and total testosterone levels compared with those who were not on COCs. The SHBG was significantly higher in the group on COCs compared with those who were not on COCs. Conclusion., The result of this study suggests that COCs in premenopausal women with HSDD are associated with lower androgen levels than those not on COCs. Further research is required to determine if low androgen levels secondary to COCs impact female sexual desire. Warnock JK, Clayton A, Croft H, Segraves R, and Biggs FC. Comparison of androgens in women with hypoactive sexual desire disorder: Those on combined oral contraceptives (COCs) vs. those not on COCs. J Sex Med 2006;3:878,882. [source]

    ORIGINAL RESEARCH,WOMEN's SEXUAL DYSFUNCTIONS: The Sexual Interest and Desire Inventory,Female (SIDI-F): Item Response Analyses of Data from Women Diagnosed with Hypoactive Sexual Desire Disorder

    THE JOURNAL OF SEXUAL MEDICINE, Issue 6 2005
    Terrence Sills PhD
    ABSTRACT Introduction Hypoactive sexual desire disorder (HSDD) is the most common sexual complaint in women. Currently there are no validated instruments for specifically assessing HSDD severity, or change in HSDD severity in response to treatment, in premenopausal women. The Sexual Interest and Desire Inventory,Female (SIDI-F) is a clinician-administered instrument that was developed to measure severity and change in response to treatment of HSDD. Seventeen items were included in a preliminary version of the SIDI-F, including 10 items related to desire, and seven items related to possible comorbid factors (e.g., other kinds of sexual dysfunction, general relationship satisfaction, mood, and fatigue). Aim The aim of the study was to use the outcome of item response analyses of blinded data from two randomized, placebo-controlled trials, to assist in the revision of the scale. Methods A nonparametric item response (IRT) model was used to assess the relation between item functioning and HSDD severity on this preliminary version of the SIDI-F. Results Results show that the majority of SIDI-F items demonstrated good sensitivity to differences in overall HSDD severity. That is, there was an orderly relation between differences in option selection for an item and differences in overall HSDD severity. The IRT analyses further indicated that revisions were warranted for a number of these items. Five items were not sensitive to differences in HSDD severity and were removed from the scale. Conclusion The SIDI-F is a brief, clinician-administered rating scale designed to assess severity of HSDD symptoms in women. IRT analyses show that majority of the items of the SIDI-F function well in discriminating individual differences in HSDD severity. A revised 13-item version of the SIDI-F is currently undergoing further validation. Sills T, Wunderlich G, Pyke R, Segraves RT, Leiblum S, Clayton A, Cotton D, and Evans K. The Sexual Interest and Desire Inventory,Female (SIDI-F): item response analyses of data from women diagnosed with hypoactive sexual desire disorder. J Sex Med 2005;2:801,818. [source]

    The impotent couple: low desire

    INTERNATIONAL JOURNAL OF ANDROLOGY, Issue 2005
    G. CORONA
    Summary Hypoactive sexual desire (HSD) is the deficiency of sexual fantasies and desire that should be considered as a disorder if it causes distress to the couple. In the general population, it is the most widespread sexuality-related problem. It is generally accepted that testosterone and prolactin regulate sexual desire. We recently reported that other psychobiological factors associate with HSD in a sample of almost 500 male patients attending our Outpatient Clinic for sexual dysfunction, by using SIEDY structured interview. We now originally extend investigation to a threefold broader patient sample. Considering marital parameters, perceived partner's libido and climax, patient's partner diseases, conflictual or even prolonged couple relationship were all significantly associated with an impairment of patients' sexual desire. Moreover, other lifestyle factors as satisfaction at work and/or domestic inhabitant relationship were significantly correlated to hypoactive sexual desire disorder (HSDD). Among hormonal parameters, severe hyperprolactinaemia (>700 mU/L), although rarely diagnosed (<2.0%), seems to play a greater role than the more common (23%) endocrine disease hypogonadism (testosterone < 12 nm) to the pathogenesis of HSD (RR = 7.5 [2.5,22.4] vs. 1.5 [1.1,1.9], respectively). Both mental disorders and use of medication interfering with sexual function were also significantly associated with HSDD, as well as depressive and anxiety symptoms. Finally, HSD was inversely correlated to sexual and masturbation frequency attempts. In conclusion, HSD is associated with several biological, psychological, and relational factors that can be simultaneously identified and quantified using the SIEDY structured interview. [source]

    Hypoactive sexual desire disorder; The next target for drug development?

    INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 12 2004
    Alan Riley
    No abstract is available for this article. [source]

    Differentiating Components of Sexual Well-Being in Women: Are Sexual Satisfaction and Sexual Distress Independent Constructs?

    THE JOURNAL OF SEXUAL MEDICINE, Issue 7 2010
    Kyle R. Stephenson BS
    ABSTRACT Introduction., Sexual satisfaction and sexual distress are common outcome measures in studies of sexual health and well-being. However, confusion remains as to if and how the two constructs are related. While many researchers have conceptualized satisfaction and distress as polar opposites, with a lack of satisfaction indicating high distress and vice versa, there is a growing movement to view satisfaction and distress as relatively independent factors and measure them accordingly. Aim., The study aimed to assess the level of independence between sexual satisfaction and distress in female clinical and nonclinical samples. Methods., Ninety-nine women (mean age = 25.3) undergoing treatment (traditional sex therapy and/or gingko biloba) for sexual arousal disorder with or without coexistent hypoactive sexual desire disorder and/or orgasmic disorder completed surveys assessing sexual satisfaction, sexual distress, sexual functioning, and relational functioning at pretreatment, mid-treatment, posttreatment, and follow-up. Two hundred twenty sexually healthy women (mean age = 20.25) completed similar surveys at 1-month intervals. Main Outcome Measures., Sexually dysfunctional women completed the Sexual Satisfaction Scale for Women (SSS-W), the Female Sexual Function Index (FSFI), and the Dyadic Adjustment Scale. Sexually healthy women completed the SSS-W, the FSFI, the Relationship Assessment Scale, and the Dimensions of Relationship Quality Scale. Results., Sexual satisfaction and distress were generally closely and inversely related; however, distress was more closely related to sexual functioning variables than was satisfaction in the clinical sample, and satisfaction was more closely related to relational variables than was distress in the nonclinical sample. Additionally, satisfaction and distress showed partially independent patterns of change over time, and scales of distress showed a larger change in response to treatment than did scales of satisfaction. Conclusion., Although sexual satisfaction and distress may be closely related, these findings suggest that they are, at least, partially independent constructs. Implications for research on sexual well-being and treatment outcome studies are discussed. Stephenson KR, and Meston CM. Differentiating components of sexual well-being in women: Are sexual satisfaction and sexual distress independent constructs? J Sex Med 2010;7:2458,2468. [source]

    ORIGINAL RESEARCH,BASIC SCIENCE: Acute and Repeated Flibanserin Administration in Female Rats Modulates Monoamines Differentially Across Brain Areas: A Microdialysis Study

    THE JOURNAL OF SEXUAL MEDICINE, Issue 5 2010
    Kelly A. Allers PhD
    ABSTRACT Introduction., Hypoactive sexual desire disorder (HSDD) is defined as persistent lack of sexual fantasies or desire marked by distress. With a prevalence of 10% it is the most common form of female sexual dysfunction. Recently, the serotonin-1A (5-HT1A) receptor agonist and the serotonin-2A (5-HT2A) receptor antagonist flibanserin were shown to be safe and efficacious in premenopausal women suffering from HSDD in phase III clinical trials. Aim., The current study aims to assess the effect of flibanserin on neurotransmitters serotonin (5-HT), norepinephrine (NE), dopamine (DA), glutamate, and ,-aminobutyric acid (GABA) in brain areas associated with sexual behavior. Methods., Flibanserin was administered to female Wistar rats (280,350 g). Microdialysis probes were stereotactically inserted into the mPFC, NAC, or MPOA, under isoflurane anesthesia. The extracellular levels of neurotransmitters were assessed in freely moving animals, 24 hours after the surgery. Main Outcome Measures., Dialysate levels of DA, NE, and serotonin from medial prefrontal cortex (mPFC), nucleus accumbens (NAC), and hypothalamic medial preoptic area (MPOA) from female rats. Results., Acute flibanserin administration decreased 5-HT and increased NE levels in all tested areas. DA was increased in mPFC and MPOA, but not in the NAC. Basal levels of NE in mPFC and NAC and of DA in mPFC were increased upon repeated flibanserin administration, when compared to vehicle-treated animals. The basal levels of 5-HT were not altered by repeated flibanserin administration, but basal DA and NE levels were increased in the mPFC. Glutamate and GABA levels remained unchanged following either repeated or acute flibanserin treatment. Conclusions., Systemic administration of flibanserin to female rats differentially affects the monoamine systems of the brain. This may be the mechanistic underpinning of flibanserin's therapeutic efficacy in HSDD, as sexual behavior is controlled by an intricate interplay between stimulatory (catecholaminergic) and inhibitory (serotonergic) systems. Allers KA, Dremencov E, Ceci A, Flik G, Ferger B, Cremers TIFH, Ittrich C, and Sommer B. Acute and repeated flibanserin administration in female rats modulates monoamines differentially across brain areas: A microdialysis study. J Sex Med 2010;7:1757,1767. [source]

    ORIGINAL RESEARCH,EPIDEMIOLOGY: The Incidence of Invasive Breast Cancer Among Women Prescribed Testosterone for Low Libido

    THE JOURNAL OF SEXUAL MEDICINE, Issue 7 2009
    Susan R. Davis MD
    ABSTRACT Introduction., Although the efficacy of testosterone for the treatment of hypoactive sexual desire disorder is well established, the effect of testosterone therapy on breast cancer risk remains uncertain. Aim., The incidence of invasive breast cancer among past and current testosterone users. Methods., Retrospective cohort study of 631 women ever treated with testosterone between January 1989 and December 2007 in a clinical endocrinology practice. Main Outcome Measure., The incidence of invasive breast cancer since first exposure, and the standardized incidence rate ratio (IRR) calculated using Australian age-specific incidence rates for 2005. Results., The mean age of the women at first exposure to testosterone therapy was 49.1 ± 8.2 years, median treatment duration, 1.3 years, and mean follow-up of 6.7 ± 4.6 years, providing 4,015 woman-years of follow-up. Twelve cases of invasive breast cancer occurred among 599 women breast cancer-free before treatment, giving an age adjusted IRR of 1.35 (95% confidence interval 0.76,2.38). There was no evidence of an independent effect of duration of exposure on breast cancer risk. Conclusion., In this study, testosterone use was not associated with a significant increase in breast cancer risk. Davis SR, Wolfe R, Farrugia H, Ferdinand A, and Bell RJ. The incidence of invasive breast cancer among women prescribed testosterone for low libido. J Sex Med 2009;6:1850,1856. [source]

    ORIGINAL RESEARCH,OUTCOMES ASSESSMENT: Validation of the Female Sexual Distress Scale-Revised for Assessing Distress in Women with Hypoactive Sexual Desire Disorder

    THE JOURNAL OF SEXUAL MEDICINE, Issue 2 2008
    Leonard DeRogatis PhD
    ABSTRACT Introduction., The concept of sexually related personal distress is currently central to the diagnosis of all female sexual dysfunctions (FSD). In the current study, we have focused on validating a slightly revised version of the Female Sexual Distress Scale (FSDS), the FSDS-Revised (FSDS-R), to enhance the sensitivity of the instrument with patients suffering from hypoactive sexual desire disorder (HSDD). In addition, we have attempted to extend the validation generalizability of the scale by demonstrating that both instruments possess reliability and discriminative validity in premenopausal women with HSDD. Aim., To assess the validity of the revised version of the FSDS, the FSDS-R, for measuring sexual distress in women with HSDD. Methods., A prospective methodological study carried out at 27 centers in North America enrolled 296 women aged 18,50 years with HSDD, another female sexual dysfunction (FSD), or no FSD. The subjects completed the FSDS-R at baseline, day 7, and day 28, with a 30-day recall at baseline and with a 7-day recall on days 7 and 28. Main Outcome Measures., Receiver operating characteristic (ROC) analyses of FSDS, FSDS-R, and FSDS-R item 13 were used for the differentiation of HSDD from no FSD, while intraclass correlation coefficient (ICC) was used to estimate test,retest reliability. Cronbach's coefficient alpha was used to measure the internal consistency of the FSDS-R and Pearson's correlation coefficient to assess FSDS, FSDS-R, and FSDS-R item 13 with different recall periods (7 and 30 days). Results., Mean total FSDS, FSDS-R, and FSDS-R item 13 scores with either recall period were significantly higher (P < 0.0001) in women with FSD or HSDD than in women with no FSD, showing both tests had discriminant validity. ROC analysis confirmed these findings, while an ICC of >0.74 showed the test,retest reliability of both scales, including FSDS-R item 13 alone, and Cronbach's coefficient alpha of >0.86 confirmed the internal consistency of both tests. Conclusions., Consistent with the FSDS, the FSDS-R demonstrated good discriminant validity, high test,retest reliability, and a high degree of internal consistency in measuring sexually related personal distress in women with HSDD. FSDS-R item 13 alone also demonstrated good discriminant validity and test,retest reliability. DeRogatis L, Clayton A, Lewis-D'Agostino D, Wunderlich G, and Fu Y. Validation of the female sexual distress scale revised for assessing distress in women with hypoactive sexual desire disorder. J Sex Med 2008;5:357,364. [source]

    Methods to Determine the Minimum Important Difference for a Sexual Event Diary Used by Postmenopausal Women with Hypoactive Sexual Desire Disorder

    THE JOURNAL OF SEXUAL MEDICINE, Issue 5 2007
    Tara Symonds PhD
    ABSTRACT Introduction., Recently, there has been much discussion in the literature about how to determine the meaningfulness of results generated from a patient-reported outcome measure. A number of reviews have shown that there are two main approaches: anchor- and distribution-based approaches for determining the minimum important difference (MID) for a new measure. There are issues with calculating an MID using each method: Will the two approaches give the same estimate? If the estimates differ, how do you decide on one estimate? Would asking patients directly be more beneficial? Aim., A case study was presented to address these issues based on a newly developed diary assessing number of satisfactory sexual events (SSEs) per week in women with hypoactive sexual desire disorder (HSDD). Methods., Anchor- and distribution-based estimates were generated from data gathered in two double-blind, placebo-controlled, parallel group trials for the treatment of HSDD (N = 788). A novel interview study was used to ask women directly about an MID for SSEs (N = 77). Main Outcome Measures., Defining the MID for an SSE diary in women with HSDD. Results., The estimates varied, producing a range of mean MID estimates between 0.04 and 0.46 SSEs per week. Conclusion., We recommend that rather than defining the MID, a range should be selected from the set of estimates formed by the limits of the 95% confidence intervals. Symonds T, Spino C, Sisson M, Soni P, Martin M, Gunter L, and Patrick DL. Methods to determine the minimum important difference for a sexual event diary used by postmenopausal women with hypoactive sexual desire disorder. J Sex Med 2007;4;1328,1335. [source]

    ORIGINAL RESEARCH: Prevalence and Evaluation of Sexual Health Problems,HSDD in Europe

    THE JOURNAL OF SEXUAL MEDICINE, Issue 2007
    Alessandra Graziottin MD
    ABSTRACT Introduction., The complex condition of the menopause is experienced by all women going through the physical and emotional changes associated with ovarian sexual hormones loss. It may impact directly on their physical and mental health. Aim., The complexity of this condition makes it necessary to accumulate large bodies of data to define the patterns and trends in its evaluable manifestations. To this end, large amounts of data were collected on women from France, Germany, Italy, and the United Kingdom, via the Women's International Survey on Health and Sexuality. Main Outcome Measures., The key measures within the survey were the Profile of Female of Sexual Function© (PFSF©) and the Personal Distress Scale© (PDS©). Results., The survey yielded 2,467 responders aged between 20 and 70, capturing women with surgical and natural menopausal status and those with premenopausal status. In the four EU countries studied, sexual activity decreases by age. An increase in female sexual dysfunction (FSD), particularly loss of sexual desire, is directly correlated with increasing age. However, the distress associated with loss of sexual desire is inversely correlated with age. Cultural and context-dependent factors modulate the percentage of any FSD in the different European countries. This is exemplified in the significant intercountry variation observed in the percentage of low desire in women aged 20,49, with normal ovarian function. However, when women undergo surgical menopause, with concomitant loss of their sexual hormones, the culture-related differences are blunted. Conclusions., The findings of this survey have implications for the understanding of hypoactive sexual desire disorder (HSDD), not only the way it should be assessed in clinical practice, but also the most appropriate means for its treatment. Testosterone deficiency is a significant cause of HSDD, and new therapies have been investigated which offer considerable potential to address this hormonal etiology. Graziottin A. Prevalence and evaluation of sexual health problems,HSDD in Europe. J Sex Med 2007;4(suppl 3):211,219. [source]

    ORIGINAL RESEARCH,ENDOCRINOLOGY: Transdermal Testosterone Gel prn Application for Hypoactive Sexual Desire Disorder in Premenopausal Women: A Controlled Pilot Study of the Effects on the Arizona Sexual Experiences Scale for Females and Sexual Function Questionnaire

    THE JOURNAL OF SEXUAL MEDICINE, Issue 1 2007
    Bella Chudakov MD
    ABSTRACT Introduction., Several studies suggest that increased plasma testosterone can improve sexual function and desire in post-oophorectomy or postmenopausal women. However, side effects of chronic daily testosterone raise questions about the generalizability of this treatment approach. Sublingual testosterone was reported to cause testosterone levels to peak after 15 minutes and then decline to baseline levels within 90 minutes. Three to 4 hours after reaching testosterone peak, increased genital sensations and sexual lust were reported. Aim., We hypothesized that a singe dose of testosterone given 4,8 hours prior to planned intercourse in women with hypoactive sexual desire disorder (HSDD) might increase desire without side effects associated with chronic use. Methods., The design was randomized double-blind crossover. Premenstrual women with HSDD received eight packets of gel or identical placebo for use before intercourse twice weekly for 1 month. For a second month, the alternate treatment was given. Main Outcome Measures., Ratings were performed using the patient-rated Arizona Sexual Experiences Scale for females and the clinician-rated Sexual Function Questionnaire (SFQ-V1). Results., Ten patients completed the study. On the five-item self-report Arizona, the item "How easily are you aroused?" was significantly improved on testosterone gel vs. placebo, P = 0.03. There were similar trends on the physician-rated SFQ-V1 "arousal,sensation" cluster. Conclusions., These preliminary results suggest that testosterone gel given prn before intercourse has effects on sexual arousal, and further research is needed to define dosage and time schedule to optimize this effect and determine its clinical relevance. Chudakov B, Ben Zion IZ, and Belmaker RH. Transdermal testosterone gel prn application for hypoactive sexual desire disorder in premenopausal women: A controlled pilot study of the effects on the Arizona Sexual Experiences Scale for females and Sexual Function Questionnaire. J Sex Med 2007;4:204,208. [source]

    ORIGINAL RESEARCH,WOMEN'S SEXUAL HEALTH: Comparison of Androgens in Women with Hypoactive Sexual Desire Disorder: Those on Combined Oral Contraceptives (COCs) vs.

    THE JOURNAL OF SEXUAL MEDICINE, Issue 5 2006
    Those not on COCs
    ABSTRACT Introduction., Approximately one out of four sexually active women in the United States uses some form of hormonal contraceptive method because they provide the most effective reversible method of birth control available. However, little attention has been paid to possible adverse effects of combined oral contraceptives (COCs) on sexual functioning. Aims., The aim of this study was to examine the potential effects of COCs on women with hypoactive sexual desire disorder (HSDD). It was hypothesized that female patients with generalized, acquired HSDD on COCs have lower androgen levels than those not on COCs. Methods., The patients were healthy premenopausal women with HSDD, aged 22,50 years. Subjects had a history of adequate sexual desire, interest, and functioning. Participants were required to be in a stable, monogamous, heterosexual relationship and were screened for any medication or medical or psychiatric disorders that impact desire. The patients met operational criteria for global, acquired HSDD. The 106 patients were divided into two groups: those on COCs (N = 43) and those not on COCs (N = 63). A two-tailed t -test comparison was made between the two groups comparing free and total testosterone and sex hormone-binding globulin (SHBG). Main Outcome Measures., The main outcome measures are the differences between the two groups comparing free testosterone, total testosterone, and SHBG. Results., These patients with HSDD on COCs had significantly lower free and total testosterone levels compared with those who were not on COCs. The SHBG was significantly higher in the group on COCs compared with those who were not on COCs. Conclusion., The result of this study suggests that COCs in premenopausal women with HSDD are associated with lower androgen levels than those not on COCs. Further research is required to determine if low androgen levels secondary to COCs impact female sexual desire. Warnock JK, Clayton A, Croft H, Segraves R, and Biggs FC. Comparison of androgens in women with hypoactive sexual desire disorder: Those on combined oral contraceptives (COCs) vs. those not on COCs. J Sex Med 2006;3:878,882. [source]

    ORIGINAL RESEARCH,WOMEN's SEXUAL DYSFUNCTIONS: The Sexual Interest and Desire Inventory,Female (SIDI-F): Item Response Analyses of Data from Women Diagnosed with Hypoactive Sexual Desire Disorder

    THE JOURNAL OF SEXUAL MEDICINE, Issue 6 2005
    Terrence Sills PhD
    ABSTRACT Introduction Hypoactive sexual desire disorder (HSDD) is the most common sexual complaint in women. Currently there are no validated instruments for specifically assessing HSDD severity, or change in HSDD severity in response to treatment, in premenopausal women. The Sexual Interest and Desire Inventory,Female (SIDI-F) is a clinician-administered instrument that was developed to measure severity and change in response to treatment of HSDD. Seventeen items were included in a preliminary version of the SIDI-F, including 10 items related to desire, and seven items related to possible comorbid factors (e.g., other kinds of sexual dysfunction, general relationship satisfaction, mood, and fatigue). Aim The aim of the study was to use the outcome of item response analyses of blinded data from two randomized, placebo-controlled trials, to assist in the revision of the scale. Methods A nonparametric item response (IRT) model was used to assess the relation between item functioning and HSDD severity on this preliminary version of the SIDI-F. Results Results show that the majority of SIDI-F items demonstrated good sensitivity to differences in overall HSDD severity. That is, there was an orderly relation between differences in option selection for an item and differences in overall HSDD severity. The IRT analyses further indicated that revisions were warranted for a number of these items. Five items were not sensitive to differences in HSDD severity and were removed from the scale. Conclusion The SIDI-F is a brief, clinician-administered rating scale designed to assess severity of HSDD symptoms in women. IRT analyses show that majority of the items of the SIDI-F function well in discriminating individual differences in HSDD severity. A revised 13-item version of the SIDI-F is currently undergoing further validation. Sills T, Wunderlich G, Pyke R, Segraves RT, Leiblum S, Clayton A, Cotton D, and Evans K. The Sexual Interest and Desire Inventory,Female (SIDI-F): item response analyses of data from women diagnosed with hypoactive sexual desire disorder. J Sex Med 2005;2:801,818. [source]

    Endocrine Aspects of Female Sexual Dysfunction

    THE JOURNAL OF SEXUAL MEDICINE, Issue 1 2004
    Susan R. Davis MD
    ABSTRACT Introduction., Various endogenous hormones, including estrogen, testosterone, progesterone and prolactin, may influence female sexual function. Aim., To provide recommendations for the diagnosis and treatment of women with endocrinologic sexual difficulties. Methods., The Endocrine Aspects of Female Sexual Dysfunction Committee was part of a multidisciplinary International Consultation. It included four experts from two countries and several peer reviewers. Main Outcome Measure., Expert opinion was based on committee discussion, a comprehensive literature review and evidence-based grading of available publications. Results., The impact of hormones on female sexual function and their etiological roles in dysfunction is complex. Research data are limited as studies have been hampered by lack of precise hormonal assays and validated measures of sexual function in women. Sex steroid insufficiency is associated with urogenital atrophy and may also adversely affect central sexual thought processes. Systemic estrogen/estrogen progestin therapy alleviates climacteric symptoms but there is no evidence that this therapy specifically improves hypoactive sexual desire disorder (HSDD) in premenopausal or postmenopausal women. Exogenous testosterone has been shown in small randomized controlled trials (RCT) to improve sexual desire, arousal and sexual satisfaction in both premenopausal and postmenopausal women. However, as there is no biochemical measure that clearly identifies who to treat, use of exogenous testosterone should be considered only after other causes of HSDD have been excluded, such as depression, relationship problems and ill health. The clinical assessment of HSDD should include detailed medical, gynecologic, sexual and psychosocial history and physical examination including the external/internal genitalia. Hormonal therapy should be individualized and risks/benefits fully discussed, and all treated women should be carefully followed up and monitored for therapeutic side effects. Conclusions., There is a need for prospective, multi-institutional clinical trials to define safe and effective endocrine treatments for female sexual dysfunction. [source]

    Hypoactive sexual desire disorder: an underestimated condition in men

    BJU INTERNATIONAL, Issue 3 2005
    Eric J.H. Meuleman
    First page of article [source]