Hypoactive Sexual Desire Disorder: What the Urologist Needs to Know

REVIEW ARTICLE

Michael S Ingber¹ and Howard B Goldman²

Affiliations: ¹Department of Urology and Urogynecology, Saint Clare’s Hospital, Denville, New Jersey, USA and ²Center for Female Pelvic Medicine and Reconstructive Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA

ABSTRACT

Complaints of decreasing sexual desire in women are common. Hypoactive Sexual Desire Disorder (HSDD) is defined as the loss of sexual desire, not attributable to any other medical cause, which results in marked personal distress and is the most frequently diagnosed female sexual dysfunction. Because urologists treat women for a variety of pelvic and vaginal disorders they should feel comfortable discussing female sexual issues and take the important opportunity to help women with HSDD. Taking a good sexual history and performing a proper exam are of utmost importance when evaluating women with low sexual desire. Unfortunately there is a paucity of literature within the urologic community on this topic-likely due to a lack of awareness among physicians. Herein we review the literature of the past decade on HSDD and provide the practitioner with the basic information needed to diagnose and treat HSDD. We discuss the use of testosterone as well as potential new therapies that are currently in development. Despite the prevalence of this distressing disease, there remains a lack of widely available and accepted treatments. Nevertheless, by better understanding HSDD, urologists can play a vital role in improving the sexual health of women with female sexual dysfunction.

Keywords: hypoactive sexual desire disorder, flibanserin, testosterone, vulvodynia, vulvar vestibulitis

Correspondence: Michael Ingber, Morris Urology Associates, 16 Pocono Rd, Suite 205, Denville, NJ 07834, USA. Tel: 1 973 627 0060;
Fax: 1 973 627 6821; e-mail: ingbermd@aol.com