Hypoactive sexual disorder

Question 1

Definition

Answer 1

The absence of sexual fantasies and thoughts and/or desire for or receptivity to sexual activity that causes personal distress or difficulties in the relationship.

Question 2

Epidemiology

Answer 2

1/10 women

Question 3

Physiological causes

Answer 3

breast cancer, diabetes, depression, urinary incontinence, thyroid problems, MS

Question 4

Psychological causes

Answer 4

Relationship issues

Question 5

Risk factors

Answer 5

Negative attitudes about sexuality

Relationship difficulties (poor communication, abuse)

Partner sexual functioning

Childhood stressors

Medical conditions (diabetes mellitus, thyroid dysfunction)

Endocrine disorders (hyperprolactinemia)

Erectile dysfunction

History of emotional or physical abuse

Other psychiatric diagnosis (depression, anxiety)

Medication side effects

Stressors (job loss, bereavement)

Alcohol use

Question 6

Generalised hypoactive sexual disorder

Answer 6

general attitude towards any potential partner or situation

Question 7

Situational hypoactive sexual disorder

Answer 7

symptoms are only present with certain types of stimulation, situations or partners

Question 8

Symptoms

Answer 8

Absent or reduced interest in sexual activity

Absent or reduced sexual thoughts or fantasies

Reduced or no initiation of sexual activity

Absent or reduced sexual excitement or pleasure during most sexual activity

Absent or reduced sexual interest or arousal in response to internal or external cues, such as a partner’s attempts to initiate sexual activity

Absent or reduced genital or nonessential sensations during sexual activity

Question 9

How long are sx required for before a diagnosis

Answer 9

The symptoms must meet the criteria for at least 6 months and cause significant distress to the individual.

Question 10

Additional male sx

Answer 10

Reduced or absent sexual thoughts or fantasies

Reduced or absent desire for sexual activity

Question 11

Psychological tx

Answer 11

Individual psychotherapy

Question 12

Medication tx

Answer 12

Flibanserin

testosterone - injection, patch, buccal, implant (HCG)

Question 13

Associated co-morbidities

Answer 13

obesity
CVD
BM
anaemia

Question 14

Causes

Answer 14

Hormone imbalance:
androgen deficiency, Addison’s, hypothyroidism

Medication:
antidepressants, OCP, HRT

Surgery:
orchidectomy, bilateral oophorectomy

Psychiatric:
depression, anxiety, life/ trauma events