10/24/2014. Definitions and Epidemiology Physiology of Female Sexual Response Female Sexual Dysfunction

Size: px
Start display at page:

Download "10/24/2014. Definitions and Epidemiology Physiology of Female Sexual Response Female Sexual Dysfunction"

Transcription

1 None to report Tami Serene Rowen, M.D. M.S. Department of Obstetrics, Gynecology and Reproductive Sciences University of California, San Francisco October 24, 2014 Definitions and Epidemiology Physiology of Female Sexual Response Female Sexual Dysfunction Classification Risk Factors Evaluation Treatment A state of physical, emotional, mental and social wellbeing in relation to sexuality Not merely the absence of disease, dysfunction or infirmity Requires the possibility of safe and pleasurable experiences An important and integral aspect of human development and maturation A human right -WHO Tech Consultation Sex Health

2 Largest study(13882 women, 29 countries) 65% women sexually active in last year 38% in last week(inverse age relationship) Agrees with US data 20-37% reported sex was very/extremely important to life 76% women felt satisfactory sex is essential to maintain a relationship Sexual well being significantly correlated to self perceived overall health Do patients want to discuss sex? While 85% of adults want to discuss sexual functioning with their physicians 71% believe their physicians doesn t have the time 68% don t want to embarrass their physician 76% thought no treatment was available for their problems 22% of women over 50 report discussing sex with a physician Laumann et al, 2006; Nicolosi et al, 2004; Lindau 2007 Marwick et al, 1993; Maurice et al 1999, Lindau et al 2007 Only 25% of primary care physicians take a sex history Jonassen et al 2002 How do gynecologists do stack up? Cross sectional study of 1,154 US Gynecologists 63% ask about sexual activity 40% ask about sexual function <30% ask about sexual orientation & satisfaction Sobeicki et al 2012 Laumann 1999: 1,749 US women age ~43% prevalence based on 7 single item dichotomous questions Bancroft 2003: Interview of 987 women % prevalence of self reported distress Shifren 2008: 31,581 US women >18 years 43% reported sexual problem 22% reported sexual distress 12% reported both sexual problem and distress 2

3 Our patients would like to discuss sex More than 10% likely have a distressing problem Many of us don t ask about it Unsure how to ask Uncertainty what to ask Unfamiliar with treatment options Masters & Johnson 1964 Male Female Rewards: Sexual and nonsexual Numerous Incentives for Sex Responsive Desire Innate Sexual Desire? Sexual Receptive -ness Masters & Johnson 1964 Basson et al 2004 Sexual Arousal Sexual Stimuli 3

4 Cross sectional study 404 women Linear model was good fit in mixed population of women Circular model fit better in women with dysfunction Giles & McCabe 2009 Cross sectional study 129 nurses 2/3 subjects endorsed linear model Sexual function scores significantly lower in women who endorsed Basson model Sand & Fisher 2007 Classification of Female Sexual Dysfunction DSM IV Persistent or recurrent, causing personal distress Desire Disorders Hypoactive Sexual Desire Disorder Sexual Aversion Disorder Sexual Arousal Disorder Genital Subjective Mixed Anorgasmia Sexual Pain Disorders Dyspareunia Vaginismus Non-coital sexual pain disorders DSM V Updates Must have 6 months of sx Medical conditions, medications and other psychological dx cannot account for sx HSDD, sex aversion and arousal disorders replaced by Sexual desire/arousal disorders Vaginismus and dyspareunia are combined into genito-pelvic pain/penetration disorder Still includes Orgasmic Disorder Lack of, or significantly reduced sexual interest, manifested by 3 of the following: Absent/reduced interest in activity Absent or reduced sexual thoughts/fantasies No/reduced initiation of sexual activity Absent/reduced excitement/pleasure Absent/reduced response to cues Absent/reduced genital sensations % prevalence Shifren et al, 2008; Seagraves and Woodard,

5 Genital pain associated with sexual stimulation 8-21% among 18-59, 14% among women Etiology Vulvar Vestibulitis Endometriosis Fibroids Surgery Psychosocial Vaginal Atrophy Inadequate lubrication Laumann et al, 1999; Laumann et al, 2005; Walton et al, 2003 Absence/Reduced orgasm after sufficient sexual stimulation and arousal Prevalence % Etiology Physical Medications Hormonal Psychological Shifren et al, 2008 Brief Index of Sexual Functioning for Women (BISF-W) 22 items, 7 domains, relationship focus Taylor et al, 1994 Female Sexual Function Index (FSFI) 19 questions, 6 domains Desire, arousal, lubrication, orgasm, satisfaction, pain Rosen et al, 2000 Female Sexual Distress Scale (FSDS, FSDS-R) 20(12) items, all focused on self reported distress Derogatis et al, 2002 Profile of Female Sexual Function (PFSF) 37 items, 7 domains, validated for women w/ BSO and HSDD McHorney et al 2004 Physical and Emotional Health status is #1 predictor! Laumann et al, 1999; Laumann et al, 2006; Nicolosi et al, 2004; Lindau et al, 2007 Role of age Filled circle =desire open triangle= arousal filled square= orgasm open diamond=any. Shifren et al, Obstet Gynecol 2008 Other factors: Relationship length (inverse correlation), education, mental health status, HRT and surgical menopause Hayes, et al 2008; Dennerstein

6 Pregnancy 90% still sexually active, drops dramatically third tri Von Sydow 2009 Post partum 50% rate dyspareunia Barret et al 2000 NO relationship between PP FSD and C/S vs SVD Higher rates of FSD with episiotomy and OVD Viswanthan et al 2006; Hannah et al 2004; Klein et al 1994 Breastfeeding associated with more dyspareunia but can stim arousal Signorello et al 2001; Avery 2000 Race and Ethnicity: conflicting data on sex activity among different groups Huang et al, 2009; Avis et al, 2005 Obesity: Higher BMI associated with more FSD Bariatric Surgery significantly improves sex QOL Kolotkin et al 2006; Sawer et al 2014 WSW: Distress associated with partner status, OAB Shindel, Rowen et al 2013 Women with Disabilities: no difference if rates of SA However less sex ed, higher risk of trauma Rowen et al, in press Focused history and physical May be useful to ask patient to describe most recent sexual experience Surveys may be of use-fsds, domains of FSFI Physical Exam: consider vulvoscopy screen for vag infxn PFMD Laboratory testing as indicated by H&P SSRIs Exception is buproprion Anti Psychotics Exception is mirtazepine CHC Anti-HTN Antihistamines Chemotherapy ACOG Practice Bulletin 2011, Parrish ISWWSH 2013 Goldstein,

7 Treat underlying disorders Address relationship Address psychosexual issues Sex Education Recalibrate expectations Sexual Enhancement treatments: gels and devices Pharmacotherapy? Caruso 2001: 53 women with FSD DB PC-crossover trial Improved arousal, orgasm, frequency of sexual intercourse No dose response Strong placebo effect Berman et al 2003: 202 menopausal women on HRT with FSD, RCT Improved FIEI for women with FSAD No effect on women with HSDD No increase in successful sexual activity % of participants sildenafil/ no HSDD sildenalfil/ HSDD placebo placebo sildenalfil/ HSDD sildenafil/ no HSDD Basson et al 2002: 781 women with FSD stratified by estrogen status No effects found in all categories Estrogenized women % improved sil 100 sil50 placebo Nurnberg et al, JAMA, women w/ depression on SSRI Sildenafil mg on demand vs. placebo 73% improved sex fnc on sildenafil, 28% on placebo Significant improvement in orgasmic score( above baseline on 6 point scale, CI ), p<0.01) placebo sil50 sil 100 7

8 Evidence equivocal for sildenafil use in women with arousal/hypoactive desire disorder Possible role of sildenafil for FSD associated with SSRI use Adverse Effects of sildenafil are: congestion, flushing, headache, dyspepsia, myalgias Can t take with nitrates(hypotension) No significant adverse events reported in studies on women Postsynaptic 5-HT1A agonist/5-ht2a antagonist (sim to buspirone) 3 Phase III RCTs done concurrently with 24 weeks tx (7 total RCTs) Thorp 2012 (DAISY): 1071 women with HSDD Placebo v Flibanserin 25, 50 BID, 100 q night Significant increase (~2/month) in SSE Subjective improvement of 44-47% (30% in placebo arm) 13.4 % discontinuation rate (vs10.1%) No major AE Derogatis 2012 (VIOLET): 663 women with HSDD Placebo v Flibanserin 50 & 100 mg Slight but significant increase in satisfying sexual events (SSE) from 0.8->1.4 and 1.6 (p<0.05) No major AE 2010:Female Viagra Hits Roadblock, FDA Denies Approval Benefits did not outweigh risks-including CNS effects Not enough sexual benefit based only on SSE not on other domains of sexual health Controversy re: how to measure improvement Kingberg and Althof, 2011 Taken up by new company. FDA again denied (2013) Estrogens Demonstrated effect on vaginal vascularity and baseline moisture Regular use associated with increased sex activity May improve other health measures Can use cream 3/week Estring q 3 months Vagifem 2-3/week SERMs Ospemafine: only FDA approved tx for FSF Tibolone: has P, E, & T activity Not approved in US Gass et al, 2011; Kovalevsky 2005, Lobo 2003, Basson 2004, Shifren 2000, Davis 2006, Nappi

9 Decreased starting age 30 Davis et al, 2005 No single androgen level predictive of sexual response Male levels of T associated with improved sex health Sig SE: hyperlipidemia, CVD,?carnogenic Sherwin&Gelfan 1987 Difference versus placebo in Study n= Treatment PFSF- PFSF- SSE Arousa Desire PDS AE Braunstein 447, surgically 2005 menopausal mcg/d NR 8* ~5* NS 6% Simon surgically menopausal 300mcg/d % Davis surgically menopausal 300 mcg/d % Shifren naturally menopausal 300 mcg/d % % Davis 2008b 814 menopausal, 150 or 300 mcg/d no E2 1.4* ~10 ~8 ~-11 0% 272 naturally Panay 2010 menopausal (26% on E2) 300 mcg/d 1.2 ~ % AE= Incidence of Adverse Events, FSFI=Female Sexual Function Index, FSDS=Female Sexual Distress Scale, NR= Not Reported, NS= Not significant, PFSF =Profile of Female Sexual Function, PDS= Personal Distress Scale, SSE=Satisfying = Sta s cally Significant (p<0.05) * = Significant differences only with 300 mcg/daily patch = women taking vaginal estrogens continued on stable dosing regimens Brand Name: Intrinsa No long term safety data More BTB, no increase hyperplasia Breast Ca: 4 vs 0 (2 in first year, 1 in 2 nd ) FDA agreed to efficacy but required more long term safety data: rejected in 2004 Note: only 3 months safety data required for men Approved in Europe but no market: no longer available Shifren ASRM 2013 Testosterone Cream (10mg) 1 RCT, 36 women with HSDD, surgically menopausal, on E2 sig increase in BISF-W(8.2 point, p<0.01) no mention of adverse events El-Hague et al, 2007 Transdermal Spray (2.8-9mg) 1 RCT, 261 pre-men women inc in SSE adverse events in 11-16%(acne, hirsutism) Davis et al, 2008 Can also use T pellets, topic gels ( Axiron ) 9

10 Libigel: daily 1% gel application Committed to long term safety trial 5 year f/u BLOOM phase III trials 1172 women no significance in ANY endpoint Company went bankrupt did not release safety data Shifren ASRM 2013,; Shafer 2011 Van Kesternen et al 1997: 297 F-M Transsexuals given T for 2 mo-41 years No difference in CAD rate compared to control Dutch women Braunstein 2007 : Review of TRT in women Major AE in women appear to be hirsutism, acne, and lowering of HDL with oral T over 1-2 year time frame Tamimi et al 2006: 70,444 post-menopausal women in Nurses Health Study taking E, E+P, E+T, or no hormones over 24 years Multivariate RR for breast CA was 1.77 (CI ) for E+T, 1.15 (CI ) for E, and 1.58 (CI ) for E+P Ness et al 2009: women in WHI, E+T vs no HRT Adjusted HR1.42; 95% confidence interval, p=.67) End of Libigel meant end of Testosterone solo therapy for FDA approval of FSD Data insufficient to demonstrate sig AE, incl breast ca Off-label use: what our societies say NAMS (2005): Postmenopausal women with decreased sexual desire associated with personal distress and with no other identifiable cause may be candidates for testosterone therapy. Testosterone treatment without concomitant estrogen therapy cannot be recommended because of a lack of evidence ACOG: Practice Bulletin (2012) : Transdermal Testosterone has been shown to be effective for the short term of hypoactive sexual desire disorder, with little evidence to support long term use (longer than 6 months) Level A Lybrido: SL Testosterone +sildenafil+ buspirone (Emotional Brain, NY) To be taken prior to sexual activity Currently just completed Phase II RCT 210 women, measuring dosage and SSE Comparison group: placebo, sildenafil testosterone 10

11 Bremalenotide DHEA Oxytocin Topical Prostaglandins Zestra All With Essentially Conflicting to Negative data for Effectiveness Female Sexual Health is complex but very important to women New research has opened door to physiologic factors Any treatment should be both medical and psychosocial Reliable and proven medical therapy for women with sexual problems is currently lacking Based on both outcomes and safety concerns Questions? 11

Outline. Do Women Care about Sex? 3/22/2016. Aging and sexuality: More than just menopause. Sexual Health is. Definitions and Epidemiology

Outline. Do Women Care about Sex? 3/22/2016. Aging and sexuality: More than just menopause. Sexual Health is. Definitions and Epidemiology Outline Definitions and Epidemiology Aging and sexuality: More than just menopause Physiology, Definitions, Dysfunction Tami Rowen MD MS Assistant Professor UCSF Department of ObGyn&RS Physiology of Female

More information

Sexual Health: What s New in 2016

Sexual Health: What s New in 2016 Sexual Health: What s New in 2016 Financial Disclosures Husband full time employee Genomic Health No material in this presentation relates to this company Tami Serene Rowen Assistant Professor UCSF Department

More information

Female Sexuality Sheryl A. Kingsberg, Ph.D.

Female Sexuality Sheryl A. Kingsberg, Ph.D. Female Sexuality Sheryl A. Kingsberg, Ph.D. Professor of Reproductive Biology Case Western Reserve University School of Medicine Chief, Division of Behavioral Medicine Department of OB/GYN University Hospitals

More information

Understanding the Spectrum of Female Sexual Dysfunction

Understanding the Spectrum of Female Sexual Dysfunction . Understanding the Spectrum of Female Sexual Dysfunction Bruce Kessel, MD Chair Jeanne Leventhal Alexander, MD; Sheila Bolour, MD; Mark Elliott, PhD; Lori Futterman, RN, PhD; Jannet Huang, MD; Lee Shulman,

More information

Sexuality. The Pharmacologic Treatment of Female Sexual Dysfunction: Future Reality or Wishful Thinking? Risks of Opening the Medicine Cabinet

Sexuality. The Pharmacologic Treatment of Female Sexual Dysfunction: Future Reality or Wishful Thinking? Risks of Opening the Medicine Cabinet 5 th Annual Meeting of the North American Menopause Society October 5, 4 Washington, DC Low Libido at Midlife: Will the Answer Ever Be in Our Medicine Cabinets? The Pharmacologic Treatment of Female Sexual

More information

Psykiatri PCK/Sexologisk Klinik Medication for Female Sexual Dysfunction - where are we?

Psykiatri PCK/Sexologisk Klinik Medication for Female Sexual Dysfunction - where are we? Medication for Female Sexual Dysfunction - where are we? Annamaria Giraldi, Professor, MD, PHD Sexological Clinic Copenhagen, Denmark Disclosures Eli Lilly - lecturer Boehringer advisory board Pfizer -

More information

Sexual dysfunction: Is it all about hormones?

Sexual dysfunction: Is it all about hormones? Sexual dysfunction: Is it all about hormones? Angelica Lindén Hirschberg, MD, PhD, Professor Department of Women s and Children s Health, Karolinska Institutet and Karolinska University Hospital, Stockholm,

More information

I have no disclosures to report. Addressing Female Sexual Needs. Sexual health. Objectives. WHO definition of sexual health:

I have no disclosures to report. Addressing Female Sexual Needs. Sexual health. Objectives. WHO definition of sexual health: Addressing Female Sexual Needs I have no disclosures to report Essentials of Women s Health Conference Big Island, Hawaii July 2016 Jennifer Kerns, MD, MS, MPH Assistant Professor, UCSF Department of Obstetrics,

More information

Erin E. Stevens, MD Chair, Department of Gynecologic Oncology Billings Clinic Cancer Center January 18, 2017

Erin E. Stevens, MD Chair, Department of Gynecologic Oncology Billings Clinic Cancer Center January 18, 2017 Erin E. Stevens, MD Chair, Department of Gynecologic Oncology Billings Clinic Cancer Center January 18, 2017 Objectives Define what's normal Define female sexual dysfunction Identify the causes of female

More information

Nivedita Dhar M.D. Wayne State University April 25, 2013

Nivedita Dhar M.D. Wayne State University April 25, 2013 Female Sexual Dysfunction Nivedita Dhar M.D. Wayne State University April 25, 2013 Outline Define Sexual Health and Wellness and discuss how it is unique to each individual Discuss the current terminology

More information

Outline. Clinic Visit: Mrs. Jones 3/10/2015

Outline. Clinic Visit: Mrs. Jones 3/10/2015 Outline Kim O Connor, MD, FACP Associate Professor University of Washington General Internal Medicine Sexual Response Cycle Categories of Female Sexual Dysfunction Biopsychosocial influences History Evaluation

More information

Low sexual desire: Appropriate use of testosterone in menopausal women

Low sexual desire: Appropriate use of testosterone in menopausal women Low sexual desire: Appropriate use of testosterone in menopausal women Low-dose testosterone treatment may be considered for HSDD in carefully selected menopausal women after standard therapies have been

More information

Female sexual dysfunction

Female sexual dysfunction Drug therapy applied to sexuality Impact of POP surgery on female sexuality G. Willy Davila, MD Department of Gynecology Urogynecology/Reconstructive Pelvic Surgery Cleveland Clinic Florida Weston/Ft.

More information

An Evidence-based Review of Clinical Trial Data

An Evidence-based Review of Clinical Trial Data An Evidence-based Review of Clinical Trial Data Karen K. Miller, MD Massachusetts General Hospital Harvard Medical School Boston, MA 1 Rationale for Investigating Androgen Administration in Women: Data

More information

Sexuality and Sexual Dysfunction in Women

Sexuality and Sexual Dysfunction in Women Sexuality and Sexual Dysfunction in Women Denise M.S. Willers, MD Associate Professor of Obstetrics and Gynecology Washington University School of Medicine Disclosures No financial disclosures to make

More information

Sexual dysfunction in women with cancer: Navigating intimacy and intercourse between women and their partners

Sexual dysfunction in women with cancer: Navigating intimacy and intercourse between women and their partners Sexual dysfunction in women with cancer: Navigating intimacy and intercourse between women and their partners Don S. Dizon, MD, FACP Clinical Co-Director, Gynecologic Oncology Founder and Director, The

More information

9/30/2016. Data and Women s Preferences Should Inform the Treatment of Hypoactive Sexual Desire Disorder: The Case for Pharmacologic Agents

9/30/2016. Data and Women s Preferences Should Inform the Treatment of Hypoactive Sexual Desire Disorder: The Case for Pharmacologic Agents Data and Women s Preferences Should Inform the Treatment of Hypoactive Sexual Desire Disorder: The Case for Pharmacologic Agents Sources of Evidence for Physiological Mechanisms Modulating Sexual Desire

More information

Therapy and Sexual Health

Therapy and Sexual Health Menopausal hormone therapy and sexual health Earn 3 CPD Points online Menopausal Hormone Therapy and Sexual Health Key messages Dr Tobie De Villiers Consultant Gynaecologist Panorama MediClinic Department

More information

Flibanserin for Hypoactive Sexual Desire Disorder: Can We Bring Back that Loving Feeling?

Flibanserin for Hypoactive Sexual Desire Disorder: Can We Bring Back that Loving Feeling? Flibanserin for Hypoactive Sexual Desire Disorder: Can We Bring Back that Loving Feeling? Lori D. Watkins, Pharm.D PGY1 Pharmacy Practice Resident Methodist Hospital, San Antonio, Texas Division of Pharmacotherapy,

More information

Addyi (flibanserin) When Policy Topic is covered Coverage of Addyi is recommended in those who meet the following criteria:

Addyi (flibanserin) When Policy Topic is covered Coverage of Addyi is recommended in those who meet the following criteria: Addyi (flibanserin) Policy Number: 5.01.605 Last Review: 10/2018 Origination: 10/2015 Next Review: 10/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage for Addyi when

More information

Dr. Maliheh Keshvari

Dr. Maliheh Keshvari 1 Dr. Maliheh Keshvari Assistant professor of Urology Fellowship in Female Urology Mashhad University of Medical Sciences 2 Female Sexual Function and Dysfunction 3 It was not until recently that urologists

More information

Women s sexuality, current debates

Women s sexuality, current debates Women s sexuality, current debates Denise Medico, M.Sc., M.A., Ph.D cand. Psychologist, Sexologist Training Course in Reproductive Health Research WHO Geneva 2008 (De)Constructing women s sexuality A dominant

More information

Resilient Intimacy. Richa Sood, M.D.

Resilient Intimacy. Richa Sood, M.D. Resilient Intimacy Richa Sood, M.D. Disclosures No financial conflicts My specialty is Female Sexual Dysfunction Common Questions What is normal sexuality, and how does it change with medical illness?

More information

The Clinical Effect of Androgen Replacement Therapy for Female Sexual Dysfunction

The Clinical Effect of Androgen Replacement Therapy for Female Sexual Dysfunction Original Article Ewha Med J 2011;34(2):33-38 pissn 2234-3180 / eissn 2234-2591 The Clinical Effect of Androgen Replacement Therapy for Female Sexual Dysfunction Seong Ju Lee, Woo Sik Chung, Hana Yoon Department

More information

Updating the Female Nomenclature: ICSM, ISSWSH, and ICD-11 Classification. Sharon J. Parish, MD, IF, NCMP 2017 Annual Scientific Program May 12, 2017

Updating the Female Nomenclature: ICSM, ISSWSH, and ICD-11 Classification. Sharon J. Parish, MD, IF, NCMP 2017 Annual Scientific Program May 12, 2017 Updating the Female Nomenclature: ICSM, ISSWSH, and ICD-11 Classification Sharon J. Parish, MD, IF, NCMP 2017 Annual Scientific Program May 12, 2017 Disclosures Advisory Board Palatin, Valeant Speaker

More information

85% 98% 6/12/2018. Disclosures. There is a need. There is a need and that need is unmet. Objectives. Barriers to meeting sexual health needs

85% 98% 6/12/2018. Disclosures. There is a need. There is a need and that need is unmet. Objectives. Barriers to meeting sexual health needs Disclosures No financial disclosures Addressing the Sexual Health Needs of Cancer Survivors: Applying Theory and Research to Practice Kristen M. Carpenter, Ph.D. June 11, 2018 There is a need There is

More information

Mayo Clin Proc, July 2002, Vol 77 Female Sexual Dysfunction Sexual pain disorder: the persistent or recurrent genital pain associated with non

Mayo Clin Proc, July 2002, Vol 77 Female Sexual Dysfunction Sexual pain disorder: the persistent or recurrent genital pain associated with non 698 Concise Review for Clinicians Female Sexual Dysfunction DEBORAH J. LIGHTNER, MD Female sexual dysfunction (FSD) was recently recognized as arising from multiple organic etiologies; it is not primarily

More information

OBSTETRICS & GYNECOLOGY

OBSTETRICS & GYNECOLOGY JANUARY 2012 COMPOUNDING PHARMACY SOLUTIONS PRESCRIPTION COMPOUNDING WWW.CPSRXS. COM We customize individual prescriptions for the specific needs of our patients. INSIDE THIS ISSUE: Female Sexual Arousal

More information

Leslie R. Schover, PhD Department of Behavioral Science

Leslie R. Schover, PhD Department of Behavioral Science Causes and Treatments of Low Sexual Desire in Breast Cancer Survivors Leslie R. Schover, PhD Department of Behavioral Science IMPORTANCE OF SEX TO BREAST CANCER SURVIVORS Livestrong 2006 Post-Treatment

More information

THE BIG QUESTION NEW INSIGHTS INTO FEMALE SEXUAL DESIRE DISORDERS SEXUAL DESIRE DISORDERS - COMMON IN WOMEN

THE BIG QUESTION NEW INSIGHTS INTO FEMALE SEXUAL DESIRE DISORDERS SEXUAL DESIRE DISORDERS - COMMON IN WOMEN NEW INSIGHTS INTO FEMALE SEXUAL DESIRE DISORDERS DISCLOSURES - NIL Dr Rosie King MB BS FAChSHM OUTLINE Prevalence of desire disorders in women Libido and limerence Unrealistic Sexpectations impact of the

More information

Hypoactive Sexual Desire Disorder (HSDD)

Hypoactive Sexual Desire Disorder (HSDD) Hypoactive Sexual Desire Disorder (HSDD) Sharon J. Parish, MD Professor of Medicine in Clinical Psychiatry; Professor of Clinical Medicine 10/07/17 shp9079@med.cornell.edu 1 Conflict Of Interest Disclosure

More information

Sexological aspects of genital pain

Sexological aspects of genital pain Sexological aspects of genital pain Annamaria Giraldi, professor, MD, PHD Sexological Clinic, Psychiatric Centre Copenhagen 1 Disclosures Speaker: Eli Lilly, Pfizer Consultant: Eli Lilly,Palatin 2 Agenda

More information

Southern California Center for Sexual Health and Survivorship Medicine Inc, Newport Beach, CA 3

Southern California Center for Sexual Health and Survivorship Medicine Inc, Newport Beach, CA 3 The WISDOM survey: Physicians Level of Comfort Prescribing Treatment for Vulvar and Vaginal Atrophy (VVA) Symptoms in Women with a Predisposition or History of Breast Cancer Lisa Larkin, MD 1 ; Michael

More information

Transdermal Testosterone For Menopause-Related Hyposexual Desire Disorder: Current Guidelines And Provider Perceptions, Knowledge, And Practice

Transdermal Testosterone For Menopause-Related Hyposexual Desire Disorder: Current Guidelines And Provider Perceptions, Knowledge, And Practice University of Vermont ScholarWorks @ UVM Graduate College Dissertations and Theses Dissertations and Theses 2017 Transdermal Testosterone For Menopause-Related Hyposexual Desire Disorder: Current Guidelines

More information

ACTIVITY DISCLAIMER DISCLOSURE. Associated Session(s) Learning Objectives. Female Sexual Dysfunction: Demystifying the Secret Garden

ACTIVITY DISCLAIMER DISCLOSURE. Associated Session(s) Learning Objectives. Female Sexual Dysfunction: Demystifying the Secret Garden ACTIVITY DISCLAIMER Female Sexual Dysfunction: Demystifying the Secret Garden Phyllis MacGilvray, MD, FAAFP The material presented here is being made available by the American Academy of Family Physicians

More information

Sexuality After the Diagnosis of Ovarian Cancer

Sexuality After the Diagnosis of Ovarian Cancer Sexuality After the Diagnosis of Ovarian Cancer June La Valleur, MD, FACOG, Sexual Health Counselor Associate Professor, Ret., University of Minnesota Medical School Sexual Health Consultant at Skyhill

More information

Assessment of female sexual dysfunction: review of validated methods

Assessment of female sexual dysfunction: review of validated methods FERTILITY AND STERILITY VOL. 77, NO. 4, SUPPL 4, APRIL 2002 Copyright 2002 American Society for Reproductive Medicine Published by Elsevier Science Inc. Printed on acid-free paper in U.S.A. Assessment

More information

Women s Sexual Interest/Desire Disorder : Implications of New Definition

Women s Sexual Interest/Desire Disorder : Implications of New Definition Women s Sexual Interest/Desire Disorder : Implications of New Definition Rosemary Basson MD FRCP(UK) Vancouver General Hospital University of British Columbia Vancouver, Canada 1 New Model of Sex Response

More information

Sexual dysfunction of chronic kidney disease. Razieh salehian.md psychiatrist

Sexual dysfunction of chronic kidney disease. Razieh salehian.md psychiatrist Sexual dysfunction of chronic kidney disease Razieh salehian.md psychiatrist Disturbances in sexual function are a common feature of chronic renal failure. Sexual dysfunction is inversely associated with

More information

Disease (diabetic neuropathy, multiple sclerosis, tumors, and, rarely, tertiary syphilis)

Disease (diabetic neuropathy, multiple sclerosis, tumors, and, rarely, tertiary syphilis) COURSES ARTICLE - THERAPYTOOLS.US Individual Planning: A Treatment Plan Overview for Adult Men with Sexual Performance Problems Individual Planning: A Treatment Plan Overview for Adult Men with Sexual

More information

Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive

More information

Winning the War on Women s Cancer Sexual Health & Survivorship

Winning the War on Women s Cancer Sexual Health & Survivorship Winning the War on Women s Cancer Sexual Health & Survivorship Tami Serene Rowen MD MS Assistant Professor Division of Obstetrics, Gynecology & Gynecologic subspecialties Lee-may Chen, MD Director, Division

More information

ASSESSING & MANAGING. Female sexual 2.0 CONTACT HOURS The Nurse Practitioner Vol. 34, No. 1

ASSESSING & MANAGING. Female sexual 2.0 CONTACT HOURS The Nurse Practitioner Vol. 34, No. 1 ASSESSING & MANAGING Female sexual 2.0 CONTACT HOURS 42 The Nurse Practitioner Vol. 34, No. 1 www.tnpj.com dysfunction Clair Kaplan, RN/MSN, APRN (WHNP), MHS, MT (ASCP) T he prevalence of female sexual

More information

OB/GYN Update: Menopausal Management What Does The Evidence Show? Rebecca Levy-Gantt D.O. PremierObGyn Napa Inc.

OB/GYN Update: Menopausal Management What Does The Evidence Show? Rebecca Levy-Gantt D.O. PremierObGyn Napa Inc. OB/GYN Update: Menopausal Management What Does The Evidence Show? Rebecca Levy-Gantt D.O. PremierObGyn Napa Inc. Napa, California IMPORTANT SAFETY INFORMATION ABOUT EVAMIST: WARNING: ENDOMETRIAL CANCER,

More information

Female Sexual Dysfunction: Clinical approach

Female Sexual Dysfunction: Clinical approach Female Sexual Dysfunction: Clinical approach - What Nurses want to know - Alessandra Graziottin MD Director, Center of Gynecology and Medical Sexology H.San Raffaele Resnati, Milano, Italy Co-Director,

More information

Quick Study: Sex Therapy

Quick Study: Sex Therapy Quick Study: Sex Therapy Sexual Dysfunction: Difficulty experienced by an individual or couple during the stages of normal sexual activity including physical pleasure, desire, arousal, or orgasm. Assessing

More information

Management of Menopausal Symptoms

Management of Menopausal Symptoms Management of Menopausal Symptoms Tammie Koehler DO, FACOG 1 Menopause Permanent cessation of menstruation that occurs after the loss of ovarian activity Determined to have occurred after 1 full year of

More information

DISORDER DESIRE IN WOMEN

DISORDER DESIRE IN WOMEN FEMALE SEXUAL INTEREST / AROUSAL DISORDER & STRATEGIES TO OPTIMIZE SEXUAL DESIRE IN WOMEN Dr. Shauna Correia MDCM, FRCPC UBC Sexual Medicine Program SEACRUISES - Sexual Health & Urology - Mediterranean

More information

Dr.Anjalakshi Chandrasekar M.D.,D.G.O.,Ph.D Prof & HOD Dept.of Obstetrics & Gynaecology S.R.M.Medical College Potheri

Dr.Anjalakshi Chandrasekar M.D.,D.G.O.,Ph.D Prof & HOD Dept.of Obstetrics & Gynaecology S.R.M.Medical College Potheri Dr.Anjalakshi Chandrasekar M.D.,D.G.O.,Ph.D Prof & HOD Dept.of Obstetrics & Gynaecology S.R.M.Medical College Potheri Adolescent Adolescence is defined as Universal phenomenon of human development characterised

More information

Sexual Function and Dysfunction

Sexual Function and Dysfunction Sexual Function and Dysfunction Angie Rantell Lead Nurse / Nurse Cystoscopist Kings College Hospital, London, UK In the real world Sexual practices are changing! Sexual identities and behaviours change

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Jaspers L, Feys F, Bramer WM, Franco OH, Leusink P, Laan ETM. Efficacy and Safety of Flibanserin for the Treatment of Hypoactive Sexual Desire Disorder in Women: A Systematic

More information

A Non-Hormonal Approach to Preventing Vulvovaginal Atrophy from Aromatase Inhibitors (AIs)

A Non-Hormonal Approach to Preventing Vulvovaginal Atrophy from Aromatase Inhibitors (AIs) A Non-Hormonal Approach to Preventing Vulvovaginal Atrophy from Aromatase Inhibitors (AIs) Leslie R. Schover, PhD Department of Behavioral Science Funded by the Duncan Family Institute for Cancer Prevention

More information

Presentation 10 Feb 2, 2019

Presentation 10 Feb 2, 2019 Addressing Sexual Relationship Concerns for the Patient Treated for Cancer 2019 BREAST HEALTH: A TEAM APPROACH 2/2/2019 SARAH JAX, MA, APRN, AOCNP MINNESOTA ONCOLOGY - PLYMOUTH Objectives Discuss causes

More information

Sexual Side Aspects of Incontinence - Suburethral Sling Surgery - in Women:

Sexual Side Aspects of Incontinence - Suburethral Sling Surgery - in Women: Sexual Side Aspects of Incontinence - Suburethral Sling Surgery - in Women: Irwin Goldstein MD Director, Sexual Medicine, Alvarado Hospital, San Diego, California Clinical Professor of Surgery, University

More information

FEMALE SEXUAL DYSFUNCTION

FEMALE SEXUAL DYSFUNCTION FEMALE SEXUAL DYSFUNCTION NM 1 FEMALE SEXUAL DYSFUNCTION: What women want? Navneet Magon MS (AFMC), FCCP Obstetrician, Gynecologist & Endoscopic Surgeon navneetmagon@gmail.com NM 3 Why talk about FSD???

More information

Female Sexual Dysfunction How Can Gynaecologists Help?

Female Sexual Dysfunction How Can Gynaecologists Help? SST LO Female Sexual Dysfunction How Can Gynaecologists Help? Sue ST LO MBBS, MD, FRCOG, PDipCommPsyMed The Family Planning Association of Hong Kong, Hong Kong Sexual dysfunction in women is common; gynaecologists

More information

Sexual problems- some basic information

Sexual problems- some basic information Sexual Problems 1 Soheil A. Hanjani, MD, FACOG, FACS Obstetrics & Gynecology 830 Oak Street Brockton, MA 02301 (508) 583-4961 Fax (508) 583-4732 Soheil.Hanjani@Steward.org www.hanjanimd.com Sexual problems-

More information

ORIGINAL INVESTIGATION

ORIGINAL INVESTIGATION ORIGINAL INVESTIGATION Safety and Efficacy of a Testosterone Patch for the Treatment of Hypoactive Sexual Desire Disorder in Surgically Menopausal Women A Randomized, Placebo-Controlled Trial Glenn D.

More information

Sexual Devices: Clitoral Stimulator, Dilators and Vibrators

Sexual Devices: Clitoral Stimulator, Dilators and Vibrators Sexual Devices: Clitoral Stimulator, Dilators and Vibrators Michael L. Krychman MD Associate Clinical Attending UCI Irvine, CA Executive Director Southern California Center for Sexual Health and Survivorship

More information

WOMEN S HEALTH: A REVIEW OF THIS YEAR S MOST IMPORTANT PAPERS OVERVIEW BUT NOT. TOPICS 8/14/2009. Judith Walsh, MD, MPH Professor of Medicine UCSF

WOMEN S HEALTH: A REVIEW OF THIS YEAR S MOST IMPORTANT PAPERS OVERVIEW BUT NOT. TOPICS 8/14/2009. Judith Walsh, MD, MPH Professor of Medicine UCSF WOMEN S HEALTH: A REVIEW OF THIS YEAR S MOST IMPORTANT PAPERS Judith Walsh, MD, MPH Professor of Medicine UCSF OVERVIEW Update in Women s Health for SGIM Drs. Mary Beattie and Pam Charney Review of literature

More information

Women s sexual desire, arousal, and orgasm. Women s Sexual Desire and Arousal Disordersjsm_

Women s sexual desire, arousal, and orgasm. Women s Sexual Desire and Arousal Disordersjsm_ 586 Women s Sexual Desire and Arousal Disordersjsm_1630 586..614 Lori A. Brotto, PhD,* Johannes Bitzer, MD, PhD, Ellen Laan, PhD, Sandra Leiblum, PhD, and Mijal Luria, MD *Department of Obstetrics and

More information

Satisfying Sexual Events as Outcome Measures in Clinical Trial of Female Sexual Dysfunctionjsm_

Satisfying Sexual Events as Outcome Measures in Clinical Trial of Female Sexual Dysfunctionjsm_ Satisfying Sexual Events as Outcome Measures in Clinical Trial of Female Sexual Dysfunctionjsm_2447 1..9 1 Sheryl A. Kingsberg, PhD* and Stanley E. Althof, PhD *OB/GYN Behavioral Medicine, University Hospitals

More information

MENOPAUSE. I have no disclosures 10/11/18 OBJECTIVES WHAT S NEW? WHAT S SAFE?

MENOPAUSE. I have no disclosures 10/11/18 OBJECTIVES WHAT S NEW? WHAT S SAFE? MENOPAUSE WHAT S NEW? WHAT S SAFE? I have no disclosures Sara Whetstone, MD, MHS OBJECTIVES To describe risks of HT by age and menopause onset To recommend specific HT regimen for women who undergo early

More information

SEXUAL PAIN Home messages, a summary from Presentations, moderated Posters and Podiums

SEXUAL PAIN Home messages, a summary from Presentations, moderated Posters and Podiums SEXUAL PAIN Home messages, a summary from Presentations, moderated Posters and Podiums María Luisa Banfi, MD Gynecologist, Sexologist Montevideo, Uruguay, South America CHICAGO 2012,SMS- ISSM, World Meeting

More information

DECLARATION OF CONFLICT OF INTEREST

DECLARATION OF CONFLICT OF INTEREST DECLARATION OF CONFLICT OF INTEREST DISCLOSURE INFORMATION: Sexual Dysfunction in Men and Women with Heart Disease: What Do We Know? Elaine E. Steinke, PhD, RN The following relationships exist related

More information

New Treatments for Vaginal Health. Sarah Azad, MD El Camino Women s Medical Group

New Treatments for Vaginal Health. Sarah Azad, MD El Camino Women s Medical Group New Treatments for Vaginal Health There s Hope Sarah Azad, MD El Camino Women s Medical Group The Genitrourinary Syndrome of Menopause (GSM) Problems with genital health secondary to the changes that occur

More information

PSYCHOLOGICAL TREATMENT FOR HYPOACTIVE SEXUAL DESIRE DISORDER (HSDD) IN MEN AND WOMEN

PSYCHOLOGICAL TREATMENT FOR HYPOACTIVE SEXUAL DESIRE DISORDER (HSDD) IN MEN AND WOMEN PSYCHOLOGICAL TREATMENT FOR HYPOACTIVE SEXUAL DESIRE DISORDER (HSDD) IN MEN AND WOMEN MARITA McCABE PhD FAPS DIRECTOR INSTITUTE FOR HEALTH AND AGEING SMSNA 207 Annual Scientific Meeting May 2, 207 Boston,

More information

GP Education Series Women s cancers. GP Education Day 11 July 2016

GP Education Series Women s cancers. GP Education Day 11 July 2016 GP Education Series Women s cancers GP Education Day 11 July 2016 Sexual Consequences of Treatment for Women s Cancers Dr Isabel White Clinical Research Fellow in Psychosexual Practice The Royal Marsden

More information

OBSTETRICS & GYNECOLOGY

OBSTETRICS & GYNECOLOGY AUGUST 2011 NORLAND AVENUE PHARMACY PRESCRIPTION COMPOUNDING N ORLANDA VENUEP HARMACY. COM We customize individual prescriptions for the specific needs of our patients. INSIDE THIS ISSUE: BHRT for Menopause

More information

Clinical Study Synopsis

Clinical Study Synopsis Clinical Study Synopsis This Clinical Study Synopsis is provided for patients and healthcare professionals to increase the transparency of Bayer's clinical research. This document is not intended to replace

More information

HRT & Menopause Where Do We Stand Now?

HRT & Menopause Where Do We Stand Now? HRT & Menopause Where Do We Stand Now? Mrs. SY Hussain Consultant Gynaecologist The Holly Private Hospital Spire Roding Hospital The Wellington Hospital Discussion Points Discuss Recommendations made by

More information

Approximately 40% of women will experience. Female Sexual Dysfunction Focus on Low Desire. Clinical Expert Series

Approximately 40% of women will experience. Female Sexual Dysfunction Focus on Low Desire. Clinical Expert Series Clinical Expert Series Female Sexual Dysfunction Focus on Low Desire Sheryl A. Kingsberg, PhD, and Terri Woodard, MD Low or absent sexual desire is the most common sexual dysfunction in women, and its

More information

James H. Liu, M.D. Arthur H. Bill Professor Chair of Reproductive Biology Dept of Obstetrics and Gynecology

James H. Liu, M.D. Arthur H. Bill Professor Chair of Reproductive Biology Dept of Obstetrics and Gynecology Disclosure Estrogen Therapy After Postmenopausal Hysterectomy: Issues, Challenges, Risks/Benefits James H. Liu, M.D. Arthur H. Bill Professor Chair of Reproductive Biology Dept of Obstetrics and Gynecology

More information

Atiwut Kamudhamas, MD, DHS, Ph.D., RTCOG, ACS

Atiwut Kamudhamas, MD, DHS, Ph.D., RTCOG, ACS Atiwut Kamudhamas, MD, DHS, Ph.D., RTCOG, ACS Biography 1985-1991 - Doctor of Medicine (First Class Honor) 1991-1992 - Post-graduate certificate in clinical medical science 1992-1995 - Diplomate Thai Board

More information

FEMALE AROUSAL AND ORGASMIC COMPLAINTS IN A DIVERSE CANCER POPULATION TREATED WITH ZESTRA: A TOPICAL APPLIED BLEND OF BOTANICAL OILS

FEMALE AROUSAL AND ORGASMIC COMPLAINTS IN A DIVERSE CANCER POPULATION TREATED WITH ZESTRA: A TOPICAL APPLIED BLEND OF BOTANICAL OILS FEMALE AROUSAL AND ORGASMIC COMPLAINTS IN A DIVERSE CANCER POPULATION TREATED WITH ZESTRA: A TOPICAL APPLIED BLEND OF BOTANICAL OILS Michael L Krychman MD Executive Director of the Southern California

More information

Prevalence of Women s Sexual Desire Problems: What Criteria Do We Use?

Prevalence of Women s Sexual Desire Problems: What Criteria Do We Use? Arch Sex Behav (2013) 42:1073 1078 DOI 10.1007/s10508-013-0107-z ORIGINAL PAPER Prevalence of Women s Sexual Desire Problems: What Criteria Do We Use? Marita P. McCabe Denisa L. Goldhammer Received: 19

More information

SEXUALITY AND INTIMACY AFTER CANCER

SEXUALITY AND INTIMACY AFTER CANCER SEXUALITY AND INTIMACY AFTER CANCER Don S. Dizon, MD Head of Women s Cancers, Lifespan Cancer Institute Director of Medical Oncology, Rhode Island Hospital Associate Professor of Medicine, Warren Alpert

More information

Body image and sexuality issues after surgery or cancer

Body image and sexuality issues after surgery or cancer Body image and sexuality issues after surgery or cancer Sharon L. Bober, Ph.D. Director, Sexual Health Program Perini Family Survivors Center Dana-Farber Cancer Institute June 26, 2010 Why doesn t sex

More information

Sexuality and Contraception. Prof. J. Bitzer Dep. Obstetrics and Gynecology University Hospitals Basel

Sexuality and Contraception. Prof. J. Bitzer Dep. Obstetrics and Gynecology University Hospitals Basel Sexuality and Contraception Prof. J. Bitzer Dep. Obstetrics and Gynecology University Hospitals Basel The motivation for poeple to become sexually active Sexual Activity Wish to become pregnant Feeling

More information

Laser CO2: una terapia ambulatoriale innovativa nel trattamento delle disfunzioni sessuali femminili

Laser CO2: una terapia ambulatoriale innovativa nel trattamento delle disfunzioni sessuali femminili Obstetrics and Gynaecology Unit Functional Unit of Urogynaecology Vita-Salute San Raffaele University and San Raffaele Hospital Milan Italy Laser CO2: una terapia ambulatoriale innovativa nel trattamento

More information

Women s Health: Managing Menopause. Jane S. Sillman, MD Assistant Professor of Medicine Harvard Medical School

Women s Health: Managing Menopause. Jane S. Sillman, MD Assistant Professor of Medicine Harvard Medical School Women s Health: Managing Menopause Jane S. Sillman, MD Assistant Professor of Medicine Harvard Medical School Disclosures I have no conflicts of interest. Learning Objectives 1. Apply strategies to help

More information

WHI Estrogen--Progestin vs. Placebo (Women with intact uterus)

WHI Estrogen--Progestin vs. Placebo (Women with intact uterus) HORMONE REPLACEMENT THERAPY In the historical period it was commonly held that estrogen had two principal benefits to postmenopausal women: 1) To alleviate the constitutional symptoms related to the climacteric

More information

attitudes toward sexuality. Further, early sexual experiences and relationships, whether positive or negative, define our sexuality in adulthood. FEMA

attitudes toward sexuality. Further, early sexual experiences and relationships, whether positive or negative, define our sexuality in adulthood. FEMA CONCISE UNDERSTANDING REVIEW WOMEN S SEXUAL FOR HEALTH CLINICIANS Understanding Women s Sexual Health: A Case-Based Approach MARY L. MARNACH, MD, AND PETRA M. CASEY, MD On completion of this article, you

More information

Sexual Dysfunction in Women with Breast Cancer: An Internet-Based Intervention. Leslie R. Schover, PhD Department of Behavioral Science

Sexual Dysfunction in Women with Breast Cancer: An Internet-Based Intervention. Leslie R. Schover, PhD Department of Behavioral Science Sexual Dysfunction in Women with Breast Cancer: An Internet-Based Intervention Leslie R. Schover, PhD Department of Behavioral Science SEXUAL PROBLEMS RANK HIGH AMONG UNMET NEEDS OF SURVIVORS SEXUAL PROBLEMS

More information

Female sexual dysfunction: Definition, classification, and debates

Female sexual dysfunction: Definition, classification, and debates Available online at www.sciencedirect.com Taiwanese Journal of Obstetrics & Gynecology 52 (2013) 3e7 Review Article Female sexual dysfunction: Definition, classification, and debates Ching-Hui Chen a,b,c,

More information

Evaluation of Systemic Effects of a Vaginal Estradiol Softgel Capsule Insert (TX-004HR) in Menopausal Women with Moderate to Severe Dyspareunia

Evaluation of Systemic Effects of a Vaginal Estradiol Softgel Capsule Insert (TX-004HR) in Menopausal Women with Moderate to Severe Dyspareunia Evaluation of Systemic Effects of a Vaginal Estradiol Softgel Capsule Insert (TX-4HR) in Menopausal Women with Moderate to Severe Dyspareunia Lisa Larkin, MD 1 ; Andrew M Kaunitz, MD 2 ; James Liu, MD

More information

Presentation to the Clinical Utility of Treating Patients with Compounded Bioidentical Hormone Therapy

Presentation to the Clinical Utility of Treating Patients with Compounded Bioidentical Hormone Therapy Presentation to the Clinical Utility of Treating Patients with Compounded Bioidentical Hormone Therapy March 5, 2019 Nese Yuksel, BScPharm, PharmD, FCSHP, NCMP Professor Faculty of Pharmacy and Pharmaceutical

More information

Sex Cells The effect of hormones on peri- and post- menopausal female sexuality Dr. Cathy Caron November 24, 2011

Sex Cells The effect of hormones on peri- and post- menopausal female sexuality Dr. Cathy Caron November 24, 2011 Sex Cells The effect of hormones on peri- and post- menopausal female sexuality Dr. Cathy Caron November 24, 2011 Is sex over at menopause? Older adults are having sex 51% of women ages 50 to 59 report

More information

Carmita Abdo, MD PhD. Medical School, University of São Paulo Program of Studies in Sexuality (ProSex)

Carmita Abdo, MD PhD. Medical School, University of São Paulo Program of Studies in Sexuality (ProSex) Carmita Abdo, MD PhD Medical School, University of São Paulo Program of Studies in Sexuality (ProSex) Carmita Abdo, MD PhD As per Rule 1595/2000 of the Federal Medical Council and Resolution RDC 102/2000

More information

PLEASE SCROLL DOWN FOR ARTICLE. Full terms and conditions of use:

PLEASE SCROLL DOWN FOR ARTICLE. Full terms and conditions of use: This article was downloaded by: [Crosby, Martin G.] On: 14 May 2010 Access details: Access Details: [subscription number 922230108] Publisher Routledge Informa Ltd Registered in England and Wales Registered

More information

Interventions to Address Sexual Problems in People with Cancer

Interventions to Address Sexual Problems in People with Cancer A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO) Interventions to Address Sexual Problems in People with Cancer L. Barbera, C. Zwaal, D. Elterman, K. McPherson,

More information

Sexual Dysfunction in Women: A Practical Approach. STEPHANIE S. FAUBION, MD, and JORDAN E. RULLO, PhD, Mayo Clinic, Rochester, Minnesota

Sexual Dysfunction in Women: A Practical Approach. STEPHANIE S. FAUBION, MD, and JORDAN E. RULLO, PhD, Mayo Clinic, Rochester, Minnesota : A Practical Approach STEPHANIE S. FAUBION, MD, and JORDAN E. RULLO, PhD, Mayo Clinic, Rochester, Minnesota Sexual dysfunction in women is a common and often distressing problem that has a negative impact

More information

FEMALE SEXUAL DYSFUNCTION-DRUG THERAPY. Dr. Renee Horowitz M.D FACOG Woman s Urology Center Beaumont Hospital

FEMALE SEXUAL DYSFUNCTION-DRUG THERAPY. Dr. Renee Horowitz M.D FACOG Woman s Urology Center Beaumont Hospital FEMALE SEXUAL DYSFUNCTION-DRUG THERAPY Dr. Renee Horowitz M.D FACOG Woman s Urology Center Beaumont Hospital CONFLICT OF INTEREST SPEAKER: AMAG PHARMACEUTICALS LUMENIS DEFINITIONS DSM-IV VS DSM-V DSM IV

More information

Placebo Response in the Treatment of Women's Sexual Dysfunctions: A Review and Commentary

Placebo Response in the Treatment of Women's Sexual Dysfunctions: A Review and Commentary Journal of Sex & Marital Therapy ISSN: 0092-623X (Print) 1521-0715 (Online) Journal homepage: http://www.tandfonline.com/loi/usmt20 Placebo Response in the Treatment of Women's Sexual Dysfunctions: A Review

More information

Testosterone therapy for sexual dysfunction in postmenopausal women

Testosterone therapy for sexual dysfunction in postmenopausal women CLIMACTERIC 2008;11:181 191 Testosterone therapy for sexual dysfunction in postmenopausal women Z. Hubayter* and J. A. Simon { *Division of Reproductive Endocrinology and Infertility, Department of Gynecology

More information

Should women get testosterone by the NHS to boost their sex drives? Experts divide over the use of male hormones to cure sexual desire disorder

Should women get testosterone by the NHS to boost their sex drives? Experts divide over the use of male hormones to cure sexual desire disorder Should women get testosterone by the NHS to boost their sex drives? Experts divide over the use of male hormones to cure sexual desire disorder dailymail.co.uk/health/article-3831645/should-women-testosterone-nhs-boost-sex-drives-experts-divide-use-malehormones-cure-sexual-desire-disorder.html

More information

Sexual Health and Endometriosis. N. Pluchino, MD, PhD Division of Ob/Gyn University Hospital of Geneva

Sexual Health and Endometriosis. N. Pluchino, MD, PhD Division of Ob/Gyn University Hospital of Geneva Sexual Health and Endometriosis N. Pluchino, MD, PhD Division of Ob/Gyn University Hospital of Geneva WOMEN S SEXUAL FUNCTION Biological issues Individual Experience Psychological issues Contextual related

More information

The DSM Diagnostic Criteria for Female Sexual Arousal Disorder. Cynthia A. Graham 1,2

The DSM Diagnostic Criteria for Female Sexual Arousal Disorder. Cynthia A. Graham 1,2 The DSM Diagnostic Criteria for Female Sexual Arousal Disorder Cynthia A. Graham 1,2 1 Oxford Doctoral Course in Clinical Psychology, Warneford Hospital, Oxford, England 2 To whom correspondence should

More information

Sex & Intimacy when Living with Cancer

Sex & Intimacy when Living with Cancer Sex & Intimacy when Living with Cancer Jeffrey Albaugh, PhD, APRN, CUCNS NorthShore University Healthcare William D. & Pamela Hutel Ross Sexual Health Clinic Jalbaugh@northshore.org Sexual Dysfunction

More information

MENOPAUSAL HORMONE THERAPY 2016

MENOPAUSAL HORMONE THERAPY 2016 MENOPAUSAL HORMONE THERAPY 2016 Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at UCLA NICE provides the National Health Service advice on effective, good value healthcare.

More information