Clinical management of hypoactive sexual desire disorder in postmenopausal women

Abstract

Approximately 10% to 12% of women meet the criteria for hypoactive sexual desire disorder, with the highest prevalence in midlife women, ranging from 14.5% to 33%. Despite the negative effect on health and quality of life, most women are reluctant to discuss sexual concerns with healthcare professionals. Although healthcare professionals have the best opportunities to address these problems, most of them have limited awareness, education, and comfort about addressing sexual concerns, resulting in a conspiracy of silence. The purpose of this Practice Pearl is to improve the understanding of hypoactive sexual desire disorder, including symptoms, etiology, diagnosis, and treatment.

Counseling in menopausal women: How to address the benefits and risks of menopause hormone therapy. A FIGO position paper

“…70 In women who develop hypoactive sexual desire disorder, transdermal testosterone treatment can be used to restore sexual function, bearing in mind that proper dosing should both attain and maintain total testosterone levels in the premenopausal physiological range and that safety data are not available beyond 2 years of treatment. [71][72][73] Moreover, it should be stopped if there is no response within 6 months of treatment. 69 Women with premature and early surgically induced menopause are potential candidates for testosterone therapy because of their experience of abrupt loss of ovarian androgen and substantial prevalence of hypoactive sexual desire disorder.…”

“…In women who develop hypoactive sexual desire disorder, transdermal testosterone treatment can be used to restore sexual function, bearing in mind that proper dosing should both attain and maintain total testosterone levels in the premenopausal physiological range and that safety data are not available beyond 2 years of treatment 71–73 . Moreover, it should be stopped if there is no response within 6 months of treatment 69 .…”

Efeito da abordagem do desejo sexual hipoativo feminino pelo ginecologista em um serviço especializado de cuidado à saúde sexual da mulher

“…Adicionalmente, podem favorecer para que a mulher se engage melhor nos protocolos que envolvem a psicoterapia e/ou farmacoterapia (Clayton et al, 2018). Contribuem, ainda, para dirimir expectativas irreais ou possíveis mitos relacionados com as queixas sexuais das mulheres (Lara, et al, 2021;Kingsberg e Faubion, et al, 2022;Clayton et al, 2018). Um estudo randomizado e controlado evidenciou que um protocolo de intervenção semanal durante seis semanas com medidas educativas em sexualidade é efetivo para melhorar a queixa de DSH em mulheres (Kaviani et al 2014).…”