Wednesday, 28 November, 2007

New Insight into Female Sexual Dysfunction (FSD)

The kids. The job. The house. The cell phone, blackberry and email. With all the responsibilities many women juggle, there is often no time for romance, and in many cases, even less desire. Well over a third (40 – 45%) of adult women experience at least one symptom of sexual dysfunction, and few feel they can talk about it. Researchers are working to change the condition and this way of thinking. “Women who have sexual dysfunction should realize this may be a treatable condition, not just a personal problem,” says Thuy-Tien L. Dam, M.D. “Many women don’t know that other women experience this too, and that it might be a diagnosable disorder called Hypoactive Sexual Desire Disorder or HSDD.” Dam, is conducting a clinical trial to see whether an investigational drug is safe and effective for women with low sexual desire. HSDD is the most common form of female sexual dysfunction, characterized by decreased sexual thoughts and feelings as well as a loss of desire for sex. About 17% to 55% of women have low levels of sexual interest, depending on age. “Candidates for the study are women who have desire problems; women who once had a healthy sex-drive who now notice a big difference in desire level, for some unknown reason,” says Dam. “If we can understand the physiologic process of what’s happening, we can tailor the treatment specifically for that.” Studies have shown that erectile dysfunction in men is sometimes caused by a physiologic problem, such as reduced blood flow. There is a school of thought that perhaps physiologic changes in the female brain may be associated with female sexual dysfunction. While male erectile dysfunction is widely known, publicly discussed and treated, the U.S. Food and Drug Administration has not approved any investigational drugs for treating similar disorders in women. This study is an important step in the therapeutic options to help women regain a satisfactory sex life, and to be able to talk about it, said Dam. Novel research published in a recent issue of The Journal of Sexual Medicine supports the claim that women with hypoactive sexual desire disorder or HSDD (persistent or recurrent deficiency and/or absence of sexual fanatasies/thoughts, and/or desire for, or receptivity to, sexual activity, which causes personal distress) show noted improvement in sexual desire and sexual function following low dose testosterone treatment.
Researchers at Yale School of Medicine and the Albert Einstein College of Medicine have found that female sexual dysfunction (FSD) affects 48.2 percent of women in a new study and that these women had decreased sensation in the clitoris, which increased the risk of sexual dysfunction. "There is a paucity of data available on FSD and this study brings attention to the possibility of a neurological cause for the dysfunction," said lead author Kathleen Connell, from the Yale School of Medicine.
Connell said previous epidemiological studies have shown that about 10 million women between the ages of 50 and 74 report abnormal sexual complaints, including decreased desire, inability to reach orgasm and increased pain with intercourse. In contrast to data on men, Connell said clinical trials evaluating the physiologic mechanisms responsible for sexual function in women are few, despite reports of other investigators, which suggest that sexual dysfunctions may be more common in women than men. "The sexual response is complex and involves interaction between the nervous system, the vascular system and the musculoskeletal system," said Connell. "Alterations in any of these systems could potentially cause FSD." The team studied the pudenal nerve, which provides nerve fibers to the pelvic floor muscles and is also responsible for sensation in the genital region. They evaluated the role of genital neurological integrity and sexual function in 56 women. They used a validated screening questionnaire to identify women between ages 18 and 68 with FSD and tested vibratory and pressure sensation in the genital region. The team found that almost half of the women studied reported sexual dysfunction. Of the women with FSD, 23.2 percent had more than one form of sexual dysfunction. Those with sexual dysfunction had decreased sensation in the clitoris compared to asymptomatic women. An investigational hormone patch developed by Proctor & Gamble and now in clinical trials may offer hope to women who have experienced a decline in sexual desire. The clinical trials of a thin, nearly-transparent patch worn discreetly on the abdomen are being conducted at University Hospitals of Cleveland and more than 150 other sites in the U.S. and Canada.

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