Hypoactive Sexual Desire Disorder: International Society for the Study of Women's Sexual Health (ISSWSH) Expert Consensus Panel Review

摘要: Abstract The objective of the International Society for Study Women's Sexual Health expert consensus panel was to develop a concise, clinically relevant, evidence-based review epidemiology, physiology, pathogenesis, diagnosis, and treatment hypoactive sexual desire disorder (HSDD), dysfunction affecting approximately 10% adult women. Etiologic factors include conditions or drugs that decrease brain dopamine, melanocortin, oxytocin, norepinephrine levels augment serotonin, endocannabinoid, prolactin, opioid levels. Symptoms lack loss motivation participate in activity due absent decreased spontaneous desire, response erotic cues stimulation, ability maintain interest through at least 6 months, with accompanying distress. Treatment follows biopsychosocial model is guided by history assessment symptoms. Sex therapy has been standard treatment, although there paucity studies assessing efficacy, except mindfulness-based cognitive behavior therapy. Bupropion buspirone may be considered off-label treatments HSDD, despite limited safety efficacy data. Menopausal women HSDD benefit from testosterone as evidenced multiple clinical trials reporting some short-term safety. Currently, flibanserin only Food Drug Administration–approved medication treat premenopausal generalized acquired HSDD. Based on existing data, we hypothesize all these therapies alter central inhibitory excitatory pathways. In conclusion, significantly affects quality life can effectively managed health care providers appropriate assessments individualized treatments.