The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women

Anita H. Clayton, Irwin Goldstein, Noel N. Kim, Stanley E. Althof, Stephanie S. Faubion, Brooke M. Faught, Sharon J. Parish, James A. Simon, Linda Vignozzi, Kristin Christiansen, Susan R. Davis, Murray A. Freedman, Sheryl A. Kingsberg, Paraskevi Sofia Kirana, Lisa Larkin, Marita McCabe, Richard Sadovsky

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

The International Society for the Study of Women's Sexual Health process of care (POC) for management of hypoactive sexual desire disorder (HSDD) algorithm was developed to provide evidence-based guidelines for diagnosis and treatment of HSDD in women by health care professionals. Affecting 10% of adult females, HSDD is associated with negative emotional and psychological states and medical conditions including depression. The algorithm was developed using a modified Delphi method to reach consensus among the 17 international panelists representing multiple disciplines. The POC starts with the health care professional asking about sexual concerns, focusing on issues related to low sexual desire/interest. Diagnosis includes distinguishing between generalized acquired HSDD and other forms of low sexual interest. Biopsychosocial assessment of potentially modifiable factors facilitates initiation of treatment with education, modification of potentially modifiable factors, and, if needed, additional therapeutic intervention: sex therapy, central nervous system agents, and hormonal therapy, guided in part by menopausal status. Sex therapy includes behavior therapy, cognitive behavior therapy, and mindfulness. The only central nervous system agent currently approved by the US Food and Drug Administration (FDA) for HSDD is flibanserin in premenopausal women; use of flibanserin in postmenopausal women with HSDD is supported by data but is not FDA approved. Hormonal therapy includes off-label use of testosterone in postmenopausal women with HSDD, which is supported by data but not FDA approved. The POC incorporates monitoring the progress of therapy. In conclusion, the International Society for the Study of Women's Sexual Health POC for the management of women with HSDD provides a rational, evidence-based guideline for health care professionals to manage patients with appropriate assessments and individualized treatments.

Original languageEnglish (US)
JournalMayo Clinic Proceedings
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Psychological Sexual Dysfunctions
United States Food and Drug Administration
Central Nervous System Agents
Therapeutics
Guidelines
Off-Label Use
Delivery of Health Care
Mindfulness
Peptide Initiation Factors
Behavior Therapy
Evidence-Based Practice
Cognitive Therapy
Women's Health
Testosterone
Consensus
Depression
Psychology

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women. / Clayton, Anita H.; Goldstein, Irwin; Kim, Noel N.; Althof, Stanley E.; Faubion, Stephanie S.; Faught, Brooke M.; Parish, Sharon J.; Simon, James A.; Vignozzi, Linda; Christiansen, Kristin; Davis, Susan R.; Freedman, Murray A.; Kingsberg, Sheryl A.; Kirana, Paraskevi Sofia; Larkin, Lisa; McCabe, Marita; Sadovsky, Richard.

In: Mayo Clinic Proceedings, 01.01.2018.

Research output: Contribution to journalArticle

Clayton, AH, Goldstein, I, Kim, NN, Althof, SE, Faubion, SS, Faught, BM, Parish, SJ, Simon, JA, Vignozzi, L, Christiansen, K, Davis, SR, Freedman, MA, Kingsberg, SA, Kirana, PS, Larkin, L, McCabe, M & Sadovsky, R 2018, 'The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women', Mayo Clinic Proceedings. https://doi.org/10.1016/j.mayocp.2017.11.002
Clayton, Anita H. ; Goldstein, Irwin ; Kim, Noel N. ; Althof, Stanley E. ; Faubion, Stephanie S. ; Faught, Brooke M. ; Parish, Sharon J. ; Simon, James A. ; Vignozzi, Linda ; Christiansen, Kristin ; Davis, Susan R. ; Freedman, Murray A. ; Kingsberg, Sheryl A. ; Kirana, Paraskevi Sofia ; Larkin, Lisa ; McCabe, Marita ; Sadovsky, Richard. / The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women. In: Mayo Clinic Proceedings. 2018.
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abstract = "The International Society for the Study of Women's Sexual Health process of care (POC) for management of hypoactive sexual desire disorder (HSDD) algorithm was developed to provide evidence-based guidelines for diagnosis and treatment of HSDD in women by health care professionals. Affecting 10{\%} of adult females, HSDD is associated with negative emotional and psychological states and medical conditions including depression. The algorithm was developed using a modified Delphi method to reach consensus among the 17 international panelists representing multiple disciplines. The POC starts with the health care professional asking about sexual concerns, focusing on issues related to low sexual desire/interest. Diagnosis includes distinguishing between generalized acquired HSDD and other forms of low sexual interest. Biopsychosocial assessment of potentially modifiable factors facilitates initiation of treatment with education, modification of potentially modifiable factors, and, if needed, additional therapeutic intervention: sex therapy, central nervous system agents, and hormonal therapy, guided in part by menopausal status. Sex therapy includes behavior therapy, cognitive behavior therapy, and mindfulness. The only central nervous system agent currently approved by the US Food and Drug Administration (FDA) for HSDD is flibanserin in premenopausal women; use of flibanserin in postmenopausal women with HSDD is supported by data but is not FDA approved. Hormonal therapy includes off-label use of testosterone in postmenopausal women with HSDD, which is supported by data but not FDA approved. The POC incorporates monitoring the progress of therapy. In conclusion, the International Society for the Study of Women's Sexual Health POC for the management of women with HSDD provides a rational, evidence-based guideline for health care professionals to manage patients with appropriate assessments and individualized treatments.",
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