Management of hypoactive sexual desire disorder (HSDD)

Abstract

Female sexual interest/arousal disorder (FSIAD), formerly known as hypoactive sexual desire disorder (HSDD), is characterized by reduced sexual interest, receptivity, pleasure, response, and sensation leading to personal distress and not related to a psychological disorder, medication, or medical condition. Low desire can be linked to situational circumstances, such as dysfunctional interpersonal relationships, or may have a physiologic cause related to chronic disease, certain medications, or hormonal factors. There is abundant research demonstrating that testosterone increases sexual desire and well-being in postmenopausal women with HSDD. Based upon this evidence, the transdermal testosterone patch is approved for treatment of women with HSDD in Europe and Australia. However, in the United States, the FDA has yet to approve a testosterone product for treating HSDD in women. There are many androgen and testosterone products under investigation, compounded preparations, and FDA-approved medications for men, which are commonly prescribed off label for women. This chapter will discuss medical management of HSDD, focusing on testosterone therapies in development.