James Mich
Wed, Jun-21-06, 06:16
Gynecol Endocrinol. 2006 Jun;22(6):318-23.
Hypoactive sexual desire disorder in postmenopausal women.
Nappi RE, Wawra K, Schmitt S.
Research Center for Reproductive Medicine, Department of
Obstetrics and Gynecology, University of Pavia, Pavia, Italy.
Decreases in sex hormone levels with menopause may bring about
a number of consequences in women's general health and sexual
well-being, especially when levels decline suddenly and
prematurely, as in surgical menopause. In addition to the
well-established role of estrogens in preserving the
biological basis of sexual response, there is emerging
evidence that androgens are significant independent
determinants affecting sexual desire, activity and
satisfaction, as well as mood, energy and other components of
women's health. Hypoactive sexual desire disorder (HSDD), a
persistent absence of sexual fantasies or thoughts and/or
desire for and receptivity to sexual activity that causes
personal distress, is experienced by some postmenopausal
women. Even though conventional hormone therapy with estrogens
or estrogens and progestogens may be effective for vaginal
atrophy, increasing vaginal lubrication and reducing
dyspareunia, it has not been shown to consistently increase
sexual desire or activity and many women with sexual
dysfunction remain unresponsive. Several recent, large, phase
III studies have shown that the addition of transdermal
testosterone to conventional hormone therapy can be helpful in
surgically menopausal women presenting with HSDD. After 24
weeks of treatment in these studies, testosterone-treated
women experienced significantly greater increases in
satisfying sexual activity and sexual desire, and greater
decreases in distress, than placebo-treated women. Accurate
clinical assessment and individualized management of sexual
symptoms are fundamentally important for all menopausal women
with HSDD or other sexual problems.
Hypoactive sexual desire disorder in postmenopausal women.
Nappi RE, Wawra K, Schmitt S.
Research Center for Reproductive Medicine, Department of
Obstetrics and Gynecology, University of Pavia, Pavia, Italy.
Decreases in sex hormone levels with menopause may bring about
a number of consequences in women's general health and sexual
well-being, especially when levels decline suddenly and
prematurely, as in surgical menopause. In addition to the
well-established role of estrogens in preserving the
biological basis of sexual response, there is emerging
evidence that androgens are significant independent
determinants affecting sexual desire, activity and
satisfaction, as well as mood, energy and other components of
women's health. Hypoactive sexual desire disorder (HSDD), a
persistent absence of sexual fantasies or thoughts and/or
desire for and receptivity to sexual activity that causes
personal distress, is experienced by some postmenopausal
women. Even though conventional hormone therapy with estrogens
or estrogens and progestogens may be effective for vaginal
atrophy, increasing vaginal lubrication and reducing
dyspareunia, it has not been shown to consistently increase
sexual desire or activity and many women with sexual
dysfunction remain unresponsive. Several recent, large, phase
III studies have shown that the addition of transdermal
testosterone to conventional hormone therapy can be helpful in
surgically menopausal women presenting with HSDD. After 24
weeks of treatment in these studies, testosterone-treated
women experienced significantly greater increases in
satisfying sexual activity and sexual desire, and greater
decreases in distress, than placebo-treated women. Accurate
clinical assessment and individualized management of sexual
symptoms are fundamentally important for all menopausal women
with HSDD or other sexual problems.