Hypoactive sexual desire disorder in women: new possibilities to ensure better understanding, diagnosis, and response to treatment.

Autor:	Maseroli E; Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, Florence, 50139, Italy., Cipriani S; Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, Florence, 50139, Italy.; Department of Experimental, Clinical and Biomedical Sciences 'Mario Serio,' University of Florence, Florence, 50139, Italy.; Aware Fertility Unit, AUSL Toscana Centro, Florence, 50121, Italy.; Center for the Prevention, Diagnosis and Treatment of Infertility, Careggi University Hospital, Florence, 50134, Italy., Lanzi V; Endocrinology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, 20122, Italy.; Department of Clinical Sciences and Community Health, University of Milan, Milan, 20157, Italy., Ravelli SA; Department of Experimental, Clinical and Biomedical Sciences 'Mario Serio,' University of Florence, Florence, 50139, Italy., Annunziato M; Department of Experimental, Clinical and Biomedical Sciences 'Mario Serio,' University of Florence, Florence, 50139, Italy., Alfaroli C; Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, Florence, 50139, Italy.; Department of Experimental, Clinical and Biomedical Sciences 'Mario Serio,' University of Florence, Florence, 50139, Italy., Lippi D; Department of Experimental and Clinical Medicine, University of Florence, Florence, 50134, Italy., Cirillo M; Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, Florence, 50139, Italy.; Department of Experimental and Clinical Medicine, University of Florence, Florence, 50134, Italy., Castellini G; Psychiatric Unit, Department of Health Sciences, University of Florence, Florence, 50134, Italy., Giraldi A; Sexological Clinic, Mental Health Center Copenhagen, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen, 2200, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, 2200, Denmark., Maggi M; Department of Experimental, Clinical and Biomedical Sciences 'Mario Serio,' University of Florence, Florence, 50139, Italy.; Endocrinology Unit, Careggi University Hospital, Florence, 50134, Italy.; INBB (Istituto Nazionale Biostrutture e Biosistemi), Rome, 00136, Italy., Vignozzi L; Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, Florence, 50139, Italy.; Department of Experimental, Clinical and Biomedical Sciences 'Mario Serio,' University of Florence, Florence, 50139, Italy.; Center for the Prevention, Diagnosis and Treatment of Infertility, Careggi University Hospital, Florence, 50134, Italy.; INBB (Istituto Nazionale Biostrutture e Biosistemi), Rome, 00136, Italy.
Jazyk:	angličtina
Zdroj:	The journal of sexual medicine [J Sex Med] 2024 Sep 28; Vol. 21 (10), pp. 861-871.
DOI:	10.1093/jsxmed/qdae102
Abstrakt:	Background: Hypoactive Sexual Desire Disorder (HSDD) is a frequent sex-related problem in women; however, a specific tool to characterize HSDD subtypes based on sexual inhibitory and excitatory factors is still lacking. Aim: (1) To find a cutoff value in Sexual Inhibition Scale (SIS)/Sexual Excitation Scale (SES) scores predicting a diagnosis of HSDD in women consulting for sexual symptoms, (2) to explore the sexual inhibitory and excitatory profiles in women referred to a clinic for female sexual dysfunction by stratifying the sample according to the newfound cutoffs, and (3) to identify biopsychosocial factors significantly associated with the 2 profiles. Methods: An overall 133 women consulting for sexual symptoms were retrospectively evaluated for clinical, biochemical, and psychosexologic data collected at the first visit. A subgroup of 55 women treated with transdermal testosterone was retrospectively analyzed at baseline and the 6-month visit. Outcomes: Patients underwent physical and laboratory examinations and completed the SIS/SES, Female Sexual Function Index, Female Sexual Distress Scale-Revised, Emotional Eating Scale, and Middlesex Hospital Questionnaire. Results: Specific cutoffs for SIS1 (≥32.5; indicating threat of performance failure) and SES (≤46.5) predicted HSDD diagnosis with an accuracy of 66.4% (P = .002) and 68.7% (P < .0001), respectively. Patients with impaired SIS1 scores showed higher distress and psychopathologic symptoms, while those with impaired SES scores demonstrated lower desire and arousal and a negative association with some metabolic and hormonal parameters. SES score also showed a significant predictive value on testosterone treatment efficacy for HSDD. Clinical Translation: A better characterization of HSDD would enable individualized treatment based on the main underlying etiologies. Strengths and Limitations: Limitations of the study include the small sample size and cross-sectional retrospective design, with the choice of treatment for HSDD limited to transdermal testosterone. Strengths comprise the thorough and multifactorial evaluation of every aspect potentially affecting inhibitory and excitatory components of sexual desire. Conclusion: Validated cutoffs of SIS/SES scores could allow deep characterization of women diagnosed with HSDD, thus ensuring better tailoring of therapy and prediction of the probability of response to specific treatments. (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society for Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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