Management of hypoactive sexual desire disorder in women: current and emerging therapies

Abstract

Rossella E Nappi1,2, Ellis Martini1,2, Erica Terreno1,2, Francesca , Albani2, Valentina Santamaria1,2, Silvia Tonani MD1,2, Luca Chiovato MD2, Franco Polatti MD11Research Center for Reproductive Medicine, Section of Obstetrics and Gynecology, Department of Morphological, Eidological and Clinical Sciences, 2Gynecological Endocrinology and Menopause Unit, Department of Internal Medicine and Endocrinology, IRCCS Maugeri Foundation; University of Pavia, ItalyAbstract: Hypoactive sexual desire disorder (HSDD) is a common multifactorial condition which is characterized by a decrease in sexual desire that causes marked personal distress and/or interpersonal difficulty. The general idea that HSDD is a sexual dysfunction difficult to treat is due to the large number of potential causes and contributing factors. Indeed, a balanced approach comprising both biological and psycho-relational factors is mandatory for accurate diagnosis and tailored management in clinical practice. There are currently no approved pharmacological treatments for premenopausal women with HSDD, while transdermal testosterone is approved in Europe for postmenopausal women who experience HSDD as a result of a bilateral oophorectomy. Even though the role of sex hormones in modulating the sexual response during the entire reproductive life span of women is crucial, a better understanding of the neurobiological basis of sexual desire supports the idea that selective psychoactive agents may be proposed as nonhormonal treatments to restore the balance between excitatory and inhibitory stimuli leading to a normal sexual response cycle. We conclude that the ideal clinical approach to HSDD remains to be established in term of efficacy and safety, and further research is needed to develop specific hormonal and nonhormonal pharmacotherapies for individualized care in women.Keywords: sexual desire, distress, testosterone, psychoactive drugs, psychosexual interventionsErratum for this paper has been published