Doctors and obstetricians need to have a greater understanding of sexual dysfunction say authors of a new review published in The Obstetrician & Gynaecologist (TOG).

Hypoactive sexual desire disorder (HSDD) is one of the most common types of sexual dysfunction and can affect women of all ages. It is defined as the persistent absence of sexual thought or receptivity to sexual activity resulting in personal distress.

The review looks at the prevalence, diagnosis and treatment of HSDD. It also highlights the important role of the GP as the first port of call for many women with sexual problems and the need for physicians across the range of disciplines to develop a better understanding of the condition.

HSDD has a significant emotional impact on those who experience it and the review recommends there needs to be greater communication between doctor and patient. In undergraduate education for example the teaching of communication skills does not always extend to sexual topics. The review also recommends that gynaecologists should discuss this topic with their patients encouraging open discussion.

A recent study of 2467 women aged between 20 and 70 years looked at the relationship between HSDD and aging and noted a high incidence of HSDD among surgically menopausal women. Hysterectomy is one of the most common procedures performed by gynaecologists. In addition, women who have an oophorectomy experience a sudden decline in testosterone levels resulting in significant androgen deficiency. Androgens are involved with sexual desire, arousal and orgasm. This suggests testosterone defiency may be a causative factor for HSDD.

Furthermore, the decline in estradiol levels amongst women following the menopause can affect female sexual function. The review recommends estrogen replacement as part of a holistic approach to therapy.

As sexual dysfunction affects people differently there is no single treatment for all states the review. The treatment of HSDD requires an examination of any underlying medical factors and a detailed sexual history. Referrals to a specialist or sex therapists may also be appropriate.

Lead author on the paper, Janice Rymer, Professor of Obstetrics and Gynaecology at Kings College London, said:

"Sexual dysfunction is a cause of unhappiness and distress for many women yet for many doctors it remains a subject of which they lack knowledge or are uncomfortable discussing. This review aims to raise the awareness of HSDD and how surgically menopausal women may be much more at risk. Sexual function is a very complex matter and involves biological, psychological, relationship and socio-cultural factors. It is important that physicians across all disciplines work together on reaching a greater understanding of this disorder.

TOG's Editor -in-Chief, Jason Waugh added: "This review raises the profile of an important disorder which affects many women and can cause much distress and interpersonal difficulties. Communication between doctor and patient is crucial to addressing the problem and greater training is needed in both communication skills in this area and in awareness of the disorder."

Reference

Rymer J, Wylie K, Barnes T, Mander A, Buckler H, Dean J. Hypoactive sexual desire disorder. The Obstetrician & Gynaecologist 2010;12:237-243.

Source:
The Obstetrician & Gynaecologist