CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(05): 417-424
DOI: 10.1055/s-0041-1731410
Febrasgo Position Statement

Management of hypoactive sexual desire disorder in women in the gynecological setting

Number 5 - May 2021
1   Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
,
2   Universidade do Vale do Taquari, Lajeado, RS, Brazil. Universidade do Vale do Rio dos Sinos, Porto Alegre, RS, Brazil.
,
3   Universidade Estadual do Piauí, Floriano, PI, Brazil.
,
4   Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
,
5   Faculdade de Medicina, Pontifícia Universidade Católica de Minas Gerais, Betim, MG, Brazil.
,
6   Sociedade Goiana De Ginecologia E Obstetrícia, Goiânia, GO, Brazil.
,
7   Universidade Federal do Acre, Rio Branco, AC, Brazil.
,
8   Sociedade Brazileira de Estudos em Sexualidade Humana, Rio de Janeiro, RJ, Brazil.
,
9   Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
,
10   Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
,
11   Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
,
12   Maternidade Cândida Vargas, João Pessoa, PB, Brazil.
,
13   Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
,
14   Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
› Institutsangaben

Key-points

  • Hypoactive Sexual Desire Disorder (HSDD) is the most prevalent sexual dysfunction among women.

  • Psychological, biological, behavioral, relational and environmental factors are the main causes of HSDD and should be assessed during HSDD investigation.

  • Gynecologists should assess women's sexual problems during routine gynecological consultations.

  • Sexual education is the start point of managing HSDD, secondary to psychological, biological, behavioral, relational and environmental factors.

  • The multidisciplinary teamwork approach achieves the best results to deal with HSDD.

The National Specialty Commission for Sexology of the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO) endorses to this document. The content production is based on scientific studies on a thematic proposal and the findings presented contribute to clinical practice.




Publikationsverlauf

Artikel online veröffentlicht:
28. Juni 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 
  • References

  • 1 ICD-11 for Mortality and Morbidity Statistics [Internet]. 2020 [cited 2020 Aug 3]. Available from: https://icd.who.int/browse11/l-m/en
  • 2 McCabe MP, Sharlip ID, Lewis R, Atalla E, Balon R, Fisher AD. et al. Incidence and prevalence of sexual dysfunction in women and men: a consensus statement from the fourth international consultation on sexual medicine 2015. J Sex Med. 2016; 13 (02) 144-152
  • 3 McCool-Myers M, Theurich M, Zuelke A, Knuettel H, Apfelbacher C. Predictors of female sexual dysfunction: a systematic review and qualitative analysis through gender inequality paradigms. BMC Womens Health. 2018; 18 (01) 108
  • 4 Yazdani M, Mahmoodi Z, Azin SA, Qorbani M. The effect of counseling based on sexual self-concept via social networks on smartphone in infertile women: a randomized controlled trial. Int J Community Based Nurs Midwifery. 2019; 7 (03) 231-240
  • 5 Bitzer J, Platano G, Tschudin S, Alder J. Sexual counseling for women in the context of physical diseases: a teaching model for physicians. J Sex Med. 2007; 4 (01) 29-37
  • 6 Lara LAS, Coelho Neto MA, Martins WP, Ferriani RA, Navarro PA. Assessment of sexual function in infertile women in a gynecological care setting. J Sex Med. 2016; 13 (06) 938-944
  • 7 Lara LAS, Scalco SCP, Troncon JK, Lopes GP. A model for the management of female sexual dysfunctions. Rev Bras Ginecol Obstet. 2017; 39 (04) 184-194
  • 8 Di Francesco S, Caruso M, Robuffo I, Militello A, Toniato E. The impact of metabolic syndrome and its components on female sexual dysfunction: a narrative mini-review. Curr Urol. 2019; 12 (02) 57-63
  • 9 Otunctemur A, Dursun M, Ozbek E, Sahin S, Besiroglu H, Koklu I. et al. Effect of metabolic syndrome on sexual function in pre- and postmenopausal women. J Sex Marital Ther. 2015; 41 (04) 440-449
  • 10 Nascimento ER, Maia ACO, Nardi AE, Silva AC. Sexual dysfunction in arterial hypertension women: the role of depression and anxiety. J Affective Disord. 2015; 181: 96-100
  • 11 Polland AR, Davis M, Zeymo A, Iglesia CB. Association between comorbidities and female sexual dysfunction: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Int Urogynecol J. 2019; 30 (03) 377-383
  • 12 Nappi RE, Cucinella L. Advances in pharmacotherapy for treating female sexual dysfunction. Expert Opin Pharmacother 2015; 16 (06) 875-887
  • 13 Dèttore D, Pucciarelli M, Santarnecchi E. Anxiety and female sexual functioning: an empirical study. J Sex Marital Ther. 2013; 39 (03) 216-240
  • 14 Mitchell KR, Mercer CH, Ploubidis GB, Jones KG, Datta J, Field N. et al. Sexual function in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet 2013; 382 (9907): 1817-1829
  • 15 Basson R, Gilks T. Women's sexual dysfunction associated with psychiatric disorders and their treatment. Women's Health (Lond) 2018; 14: 1745506518762664
  • 16 Düring SW, Nielsen MØ, Bak N, Glenthøj BY, Ebdrup BH. Sexual dysfunction and hyperprolactinemia in schizophrenia before and after six weeks of D2/3 receptor blockade - An exploratory study. Psychiatry Res. 2019; 274: 58-65
  • 17 Montejo AL, Montejo L, Baldwin DS. The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management. World Psychiatry 2018; 17 (01) 3-11
  • 18 Allen K, Baban A, Munjiza J, Pappa S. Management of antipsychotic-related sexual dysfunction: systematic review. J Sex Med. 2019; 16 (12) 1978-1987
  • 19 Rappek NAM, Sidi H, Kumar J, Kamarazaman S, Das S, Masiran R. et al. Serotonin Selective Reuptake Inhibitors (SSRIs) and Female Sexual Dysfunction (FSD): hypothesis on its association and options of treatment. Curr Drug Targets 2018; 19 (12) 1352-1358
  • 20 Sidi H, Asmidar D, Hod R, Jaafar NRN, Guan NC. Hypoactive sexual desire among depressed female patients treated with selective serotonin reuptake inhibitors: a comparison between escitalopram and fluoxetine. Int J Psychiatry Clin Pract. 2012; 16 (01) 41-47
  • 21 Clayton AH, Croft HA, Handiwala L. Antidepressants and sexual dysfunction: mechanisms and clinical implications. Postgrad Med. 2014; 126 (02) 91-99
  • 22 Kennedy SH, Lam RW, McIntyre RS, Tourjman SV, Bhat V, Blier P. et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: Section 3. Pharmacological treatments. Can J Psychiatry 2016; 61 (09) 540-560
  • 23 Atmaca M. Selective serotonin reuptake inhibitor-induced sexual dysfunction: current management perspectives. Neuropsychiatr Dis Treat 2020; 16: 1043-1050
  • 24 Zethraeus N, Dreber A, Ranehill E, Blomberg L, Labrie F, von Schoultz B. et al. Combined oral contraceptives and sexual function in women-a double-blind, randomized, placebo-controlled trial. J Clin Endocrinol Metab. 2016; 101 (11) 4046-4053
  • 25 Boozalis A, Tutlam NT, Chrisman Robbins C, Peipert JF. Sexual desire and hormonal contraception. Obstet Gynecol. 2016; 127 (03) 563-572
  • 26 Sanders SA, Graham CA, Bass JL, Bancroft J. A prospective study of the effects of oral contraceptives on sexuality and wellbeing and their relationship to discontinuation. Contraception 2001; 64 (01) 51-58
  • 27 Kingsberg SA, Woodard T. Female sexual dysfunction: focus on low desire. Obstet Gynecol. 2015; 125 (02) 477-486
  • 28 Ben Thabet J, Charfeddine F, Charfi N, Baati I, Zouari L, Zouari N. et al. [Sexuality of Tunisian women: involvement of religion and culture]. Encephale 2015; 41 (02) 144-150 French
  • 29 Atallah S, Johnson-Agbakwu C, Rosenbaum T, Abdo C, Byers ES, Graham C. et al. Ethical and sociocultural aspects of sexual function and dysfunction in both sexes. J Sex Med. 2016; 13 (04) 591-606
  • 30 Kingsberg SA, Althof S, Simon JA, Bradford A, Bitzer J, Carvalho J. et al. Female sexual dysfunction-medical and psychological treatments, Committee 14. J Sex Med. 2017; 14 (12) 1463-1491
  • 31 Kellogg Spadt S, Rosenbaum TY, Dweck A, Millheiser L, Pillai-Friedman S, Krychman M. Sexual health and religion: a primer for the sexual health clinician (CME). J Sex Med. 2014; 11 (07) 1607-1618
  • 32 Mark KP, Lasslo JA. Maintaining sexual desire in long-term relationships: a systematic review and conceptual model. J Sex Res. 2018; 55 (4-5): 563-581
  • 33 Zhang J, Li F, Li H, Zhang Z, Yang B, Li H. Clinical features of and couple's attitudes towards premature ejaculation: a multicenter cross-sectional study. Aging Male 15.07.2019; [ahead of print].
  • 34 Rosen NO, Dubé JP, Corsini-Munt S, Muise A. Partners experience consequences, too: a comparison of the sexual, relational, and psychological adjustment of women with sexual interest/arousal disorder and their partners to control couples. J Sex Med. 2019; 16 (01) 83-95
  • 35 Byers ES. Beyond the birds and the bees and was it good for you?: thirty years of research on sexual communication. Can Psychol/Psychol Can. 2011; 52 (01) 20-28
  • 36 Marieke D, Joana C, Giovanni C, Erika L, Patricia P, Yacov R. et al. Sexual desire discrepancy: a position statement of the European Society for Sexual Medicine. Sex Med. 2020; 8 (02) 121-31
  • 37 Haseli A, Shariati M, Nazari AM, Keramat A, Emamian MH. Infidelity and its associated factors: a systematic review. J Sex Med. 2019; 16 (08) 1155-1169
  • 38 Fincham FD, May RW. Infidelity in romantic relationships. Curr Opin Psychol. 2017; 13: 70-74
  • 39 Hawks L, Woolhandler S, Himmelstein DU, Bor DH, Gaffney A, McCormick D. Association between forced sexual initiation and health outcomes among US women. JAMA Intern Med. 16.09.2019; e193500 [ahead of print.
  • 40 Thornton K, Chervenak J, Neal-Perry G. Menopause and sexuality. Endocrinol Metab Clin North Am. 2015; 44 (03) 649-61
  • 41 Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society. Menopause 2013; 20 (09) 888-902
  • 42 Pitsouni E, Grigoriadis T, Falagas ME, Salvatore S, Athanasiou S. Laser therapy for the genitourinary syndrome of menopause. A systematic review and meta-analysis. Maturitas 2017; 103: 78-88
  • 43 Clayton AH, Goldstein I, Kim NN, Althof SE, Faubion SS, Faught BM. et al. The International society for the study of women's sexual health process of care for management of hypoactive sexual desire disorder in women. Mayo Clin Proc. 2018; 93 (04) 467-487
  • 44 Nastri CO, Lara LA, Ferriani RA, Rosa-E-Silva ACJS, Figueiredo JBP, Martins WP. Hormone therapy for sexual function in perimenopausal and postmenopausal women. Cochrane Database Syst Rev. 2013; (06) CD009672
  • 45 Aribi L, Ben Houidi A, Masmoudi R, Chaabane K, Guermazi M, Amami O. [Female sexuality during pregnancy and postpartum: a study of 80 Tunisian women]. Tunis Med. 2012; 90 (12) 873-877 French.
  • 46 Kračun I, Tul N, Blickstein I, Velikonja VG. Quantitative and qualitative assessment of maternal sexuality during pregnancy. J Perinat Med. 2019; 47 (03) 335-340
  • 47 Woolhouse H, McDonald E, Brown S. Women's experiences of sex and intimacy after childbirth: making the adjustment to motherhood. J Psychosom Obstet Gynaecol. 2012; 33 (04) 185-190
  • 48 Fuchs A, Czech I, Sikora J, Fuchs P, Lorek M, Skrzypulec-Plinta V. et al. Sexual functioning in pregnant women. Int J Environ Res Public Health 2019; 16 (21) 4216
  • 49 Fuentealba-Torres M, Cartagena-Ramos D, Fronteira I, Lara LA, Arroyo LH, Arcoverde MAM. et al. What are the prevalence and factors associated with sexual dysfunction in breastfeeding women? A Brazilian cross-sectional analytical study. BMJ Open 2019; 9 (04) e025833
  • 50 Kainu JP, Halmesmäki E, Korttila KT, Sarvela PJ. Persistent pain after cesarean delivery and vaginal delivery: a prospective cohort study. Anesth Analg. 2016; 123 (06) 1535-1545
  • 51 Banaei M, Torkzahrani S, Ozgoli G, Azad M, Mahmoudikohani F, Pormehr-Yabandeh A. Addressing the sexual function of women during first six month after delivery: aquasiexperimental study. Mater Sociomed. 2018; 30 (02) 136-140