Both Addyi and Vyleesi treat hypoactive sexual desire disorder In order for a woman to be prescribed Addyi or Vyleesi, a doctor has to diagnose her with hypoactive sexual desire disorder, urologist Dr. Michael Ingber told Insider.
|
|
The condition is formally known as hypoactive sexual desire disorder, or HSDD.
|
|
Both treatments aim to help women with hypoactive sexual desire disorder, which affects about six million American women.
|
|
It treats a condition called hypoactive sexual desire disorder that has been removed from the Diagnostic and Statistical Manual of Mental Disorders.
|
|
The company said it would instead focus on educating doctors about the drug and the condition it treats, hypoactive sexual desire disorder.
|
|
Vyleesi, chemically known as bremelanotide, activates pathways in the brain involved in sexual desire, helping premenopausal women with hypoactive sexual desire disorder (HSDD).
|
|
The company said phase 3 studies "confirm the effectiveness" of the drug as a treatment for pre-menopausal women with hypoactive sexual desire disorder.
|
|
The Food and Drug Administration (FDA) approved a drug Friday to restore sexual desire for premenopausal women who suffer from hypoactive sexual desire disorder.
|
|
Although doctors recognize that there is (perhaps) a condition called Hypoactive Sexual Desire Disorder, many of the studies defining HSDD were sponsored by the drugmaker.
|
|
With it, Sprout developed Addyi, dubbed "female Viagra," to treat hypoactive sexual desire disorder in premenopausal women (10 percent of all women suffer from HSDD).
|
|
Fagiolini's team recruited 38 men diagnosed with either hypoactive sexual desire disorder or sexual arousal disorder – both characterized by a lack of interest in sex.
|
|
Ms. Coles responded by saying that it was critical for women to have access to the only drug on the market addressing hypoactive sexual desire disorder.
|
|
Its line of sexual health products includes a prescription-based birth control pill and Addyi, the only FDA-approved medication for women with hypoactive sexual desire disorder.
|
|
About one in 10 premenopausal women in the U.S. suffer from hypoactive sexual desire disorder, according to Unblush, a website that offers women information on the condition.
|
|
Vyleesi, known chemically as bremelanotide, works by activating pathways in the brain involved in sexual desire and response, helping premenopausal women with hypoactive sexual desire disorder (HSDD).
|
|
Flibanserin, marketed by Valeant as Addyi, was approved by the U.S. Food and Drug Administration (FDA) in 2015 to treat premenopausal women with hypoactive sexual desire disorder (HSDD).
|
|
According to Ingber, "distress" is an important part of the equation, and if a woman isn't bothered by her decreased libido, she doesn't have hypoactive sexual desire disorder.
|
|
It's intended to treat women who are premenopausal and have hypoactive sexual desire disorder, where a lack of interest in sex may cause significant distress in a woman's life.
|
|
In addition to erectile dysfunction medication, it offers the birth control pill to customers with prescriptions and Addyi, the only FDA-approved medication for women with hypoactive sexual desire disorder.
|
|
"Hypoactive Sexual Desire Disorder was actually invented by pharmaceutical companies," Adriane Fugh-Berman, MD, the director of pharmaceutical watchdog project PharmedOut, testified to the FDA advisory committee that recommended flibanserin's approval.
|
|
Hypoactive sexual desire disorder shouldn't be confused with an inability to be physically aroused, which is characterized by a lack of blood flow to the vagina and is targeted by Viagra.
|
|
It was not until August of last year that the FDA announced their approval of the first pharmaceutical, Addyi (flibanserin), designed to treat hypoactive sexual desire disorder (HSDD) in premenopausal women.
|
|
Bremelanotide, to be marketed as Vyleesi, has been approved to treat hypoactive sexual desire disorder (HSDD) in premenopausal women, and the injectable drug will be sold by AMAG Pharmaceuticals, the FDA said.
|
|
Palatin said the experimental drug, bremelanotide, demonstrated statistically significant improvement versus placebo on scales measuring levels of desire and distress in 24-week studies of more than 1,200 women diagnosed with hypoactive sexual desire disorder (HSDD).
|
|
Only women who have been diagnosed with hypoactive sexual desire disorder (HSDD), or clinically low sex drive, are eligible, and per the FDA; only doctors who have been specially trained by Sprout Pharmaceuticals can prescribe the drug.
|
|
" 5 myths about 'female Viagra' busted The International Society for the Study of Women's Sexual Health went even further, calling the study "a great disservice to the millions of pre-menopausal women suffering from (hypoactive sexual desire disorder).
|
|
It's also worth nothing that, while products like Flibanserin are meant to treat clinically low sex drive (the hotly debated hypoactive sexual desire disorder), the Aphrodisiac IV is simply meant to increase your libido by increasing your energy and improving your overall mood.
|
|
Only one previous study, published in March 2014, looked at how women's brains play a role in arousal when viewing porn, but it focused on women with hypoactive sexual desire disorder, a condition in which people's lack of sexual desire makes them feel distressed.
|
|
After online consultations with Hers doctors (included in the cost of Hers products, which can be filled by the Hers pharmacy, shipping to some 20 states, or sent to customers' own pharmacies), women can request birth control, dermatologic treatments, products for hair loss and Addyi, a prescription pill for hypoactive sexual desire disorder.
|
|
Telehealth startup Hims, a direct-to-consumer brand meant to provide solutions for men to erectile dysfunction and hair loss, launched a sister direct-to-consumer shop called Hers this week to provide women of all ages medical products such as skincare items to combat hair loss and acne, as well as birth control and Addyi, the only FDA-aproved product for hypoactive sexual desire disorder.
|
|
CT scans and MRI scans may be useful in the diagnostic testing of focal hypoactive reflexes.
|
|
There is some evidence that buspirone on its own may be useful in the treatment of hypoactive sexual desire disorder (HSDD) in women.
|
|
The term "hypoactive sexual desire" is more awkward, but more neutral with respect to the cause. The DSM-III-R estimated that about 20% of the population had HSDD.American Psychological Association (1987) In the DSM-IV (1994), the criterion that the diagnosis requires "marked distress or interpersonal difficulty" was added. The DSM-5, published in 2013, split HSDD into male hypoactive sexual desire disorder and female sexual interest/arousal disorder.
|
|
Regarding general sexual dysfunction, the ICD-10 has three main categories: Lack or loss of sexual desire (), Sexual aversion and lack of sexual enjoyment (), and Failure of genital response (). The ICD-11 replaces these with two main categories: Hypoactive sexual desire dysfunction () and Sexual arousal dysfunction (). The latter has two subcategories: Female sexual arousal dysfunction () and Male erectile dysfunction (). The difference between Hypoactive sexual desire dysfunction and Sexual arousal dysfunction is that in the former, there is a reduced or absent desire for sexual activity.
|
|
Sexual anhedonia, also known as pleasure dissociative orgasmic disorder, is a condition in which an individual cannot feel pleasure (see anhedonia) from an orgasm. It is thought to be a variant of hypoactive sexual desire disorder.
|
|
In one of the previous editions of the Diagnostic and Statistical Manual (DSM-4), a particularly low degree of sexual desire would have been the main diagnostic criteria for hypoactive sexual desire disorder (HSDD). However, since the release of the DSM-5 in 2013, the disorder has been redefined and distinguished by gender differences being female sexual interest/arousal disorder and male hypoactive sexual desire disorder. Research has found for both men and women suffering from low sexual desire on a clinical level, significantly lower levels of sexual satisfaction as well as lower levels of overall relationship adjustment are reported. Due to its adverse effects on an individual's sexual satisfaction, it has been shown to negatively affect a relationship overall.
|
|
One study suggested that areas of the prefrontal cortex are part of a network of regions including dorsal and pregenual cingulate, bilateral middle frontal gyrus, insula and superior temporal gyrus that appear to be hypoactive in people with MDD. However the authors cautioned that the exclusion criteria, lack of consistency and small samples limit results.
|
|
The company initially sold birth control, skin care and hair loss products, and prescriptions for hypoactive sexual desire disorder. Hims and Hers sell over-the-counter products and prescriptions through a subscription model. The company received media attention for its advertisements in 2018, with critics stating that the ads were too suggestive for the public subway.
|
|
This conveys that currently, there is no definitive conclusion on desire discrepancy amongst gay couples. However, when gay men are clinically diagnosed with Male Hypoactive Sexual Desire Disorder (see Desire Discrepancy Disorders below), clinicians take self-inflicted homophobia, interpersonal issues, attitude, lack of appropriate sex education and early life experience trauma into account as possible predisposition factors for the onset of the disorder.
|
|
Onset of Efficacy of Flibanserin in Premenopausal Women with Hypoactive Sexual Desire Disorder. Abstract presented at the 58th Annual Clinical Meeting of The American College of Obstetricians and Gynecologists, May 2010. The effectiveness of flibanserin was evaluated in three phase 3 clinical trials. Each of the three trials had two co-primary endpoints, one for satisfying sexual events (SSEs) and the other for sexual desire.
|
|
Bremelanotide is used for the treatment of generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. Specifically it is only recommended in those who have the condition without an underlying cause, such as medical, psychiatric, or relationship problems. It should be used at least 45 minutes before anticipated sexual activity. Only one dose per 24 hours or no more than eight doses per month is recommended.
|
|
Delirium, also known as acute confusional state, is an organically caused decline from a previous baseline mental functioning that develops over a short period of time, typically hours to days. Delirium is a syndrome encompassing disturbances in attention, consciousness, and cognition. It may also involve other neurological deficits, such as psychomotor disturbances (e.g. hyperactive, hypoactive, or mixed), impaired sleep-wake cycle, emotional disturbances, and perceptual disturbances (e.g.
|
|
Hypoactive sexual desire disorder: Prevalence and comorbidity in 906 subjects. Journal of Sex and Marital Therapy, 17, 55-58. Another issue is that, among women, there is a discrepancy between desire and arousal. After Cynthia Graham critically evaluated female sexual arousal disorder (FSAD), she found that women reported that, contrary to Masters and Johnson's model, sexual arousal sometimes preceded sexual desire; at other times, desire presented before arousal.
|
|
Competitive Technologies sued Palatin for breach of contract and to try to claim ownership of bremelanotide; the parties settled in 2008 with Palatin retaining rights to bremelanotide, returning rights to melanotan-II to Competitive Technologies, and paying $800,000. Bremelanotide was approved for use in the United States by the Food and Drug Administration (FDA) in June 2019 under the brand name Vyleesi to treat hypoactive sexual desire disorder (HSDD).
|
|
On June 18, 2010, a federal advisory panel to the US Food and Drug Administration (FDA) unanimously voted against recommending approval of flibanserin, citing an inadequate risk-benefit ratio. The Committee acknowledged the validity of hypoactive sexual desire as a diagnosis, but expressed concern with the drug's side effects and insufficient evidence for efficacy, especially the drug's failure to show a statistically significant effect on the co-primary endpoint of sexual desire. Earlier in the week, a FDA staff report also recommended non-approval of the drug. Ahead of the votes, Boehringer Ingelheim had mounted a publicity campaign to promote the controversial disorder of "hypoactive sexual desire". In 2010 the FDA issued a Complete Response Letter, stating that New Drug Application could not be approved in its current form. The letter cited several concerns, including the failure to demonstrate a statistical effect on the co-primary endpoint of sexual desire and overly restrictive entry criteria for the two Phase 3 trials.
|
|
Flibanserin, sold under the brand name Addyi, is a medication approved for the treatment of pre-menopausal women with hypoactive sexual desire disorder (HSDD). The medication increases the number of satisfying sexual events per month by about one half over placebo from a starting point of about two to three. The certainty of the estimate is low. The side effects of dizziness, sleepiness, and nausea occur about three to four times more often.
|
|
Issues for DSM-V: Sexual dysfunction, disorder, or variation along normal distribution: Toward rethinking DSM criteria of sexual dysfunctions. American Journal of Psychiatry, 164(2), 198-200. One study found that in patients with hypoactive sexual desire disorder (HSDD), 41% of women had at least one other sexual dysfunction and 18% had diagnoses in all 3 categories (that is, in desire, arousal, and orgasm disorders).Segraves, R. T. & Segraves, K. B. (1991).
|
|
There is renewed interest in the use of apomorphine to treat addiction, in both smoking cessation and alcoholism. As the drug is known to be reasonably safe for use in humans, it is a viable target for repurposing.Flow chart depicting the role of apomorphine in Alzheimer's disease.Apomorphine has been researched as a possible treatment for erectile dysfunction and female hypoactive sexual desire disorder, though the arousal effects were found not to be reliable enough.
|
|
Although these results of decreased methylation and hyperactivation of GR conflict with the effect of early life stress at the same loci, these results match previous findings that distinguish HPA activity in early life stress versus PTSD. For example, cortisol levels of HPA in response to early life stress is hyperactive, whereas it is hypoactive in PTSD. Thus, the timing of trauma and stress—whether early or later in life—can cause differing effects on HPA and GR.
|
|
Palmiter and his research group have also investigated the role of zinc as a chemical transmitter in the brain. They have discovered that it prevents excessive excitability of the CNS. Mice that do not make dopamine are found to be hypoactive and have no motivation to eat or drink. Despite their lack of thirst or hunger, these mice can be kept alive with pharmacological delivery of L-DOPA or viral gene therapy with vectors that restore L-DOPA synthesis.
|
|
One review reported hypoactivity in the prefrontal cortex of those with depression compared to controls. The prefrontal cortex is involved in emotional processing and regulation, and dysfunction of this process may be involved in the etiology of depression. One study on antidepressant treatment found an increase in PFC activity in response to administration of antidepressants. One meta analysis published in 2012 found that areas of the prefrontal cortex were hypoactive in response to negative stimuli in people with MDD.
|
|
Flibanserin is used for hypoactive sexual desire disorder among women. Those receiving flibanserin report a 0.5 increase compared to placebo in the number of times they had "satisfying sexual events". In those on flibanserin it rose from 2.8 to 4.5 times a month while women receiving placebo reported also an increase of "satisfying sexual events" from 2.7 to 3.7 times a month.Jolly E, Thorp J, Clayton AH, et al. Patients’ Perspective of Efficacy of Flibanserin in Premenopausal Women with HSDD.
|
|
The portion of the inferior frontal lobe immediately adjacent to the longitudinal fissure (and medial to the medial orbital gyrus and olfactory tract) is named the straight gyrus,(or gyrus rectus) and is continuous with the superior frontal gyrus on the medial surface. A specific function for the straight gyrus has not yet been brought to light; however, in males, greater activation of the straight gyrus within the medial orbitofrontal cortex while observing sexually visual pictures has been strongly linked to HSDD (hypoactive sexual desire disorder).
|
|
Significant overlap between atypical and other forms of depression have been observed, though studies suggest there are differentiating factors within the various pathophysiological models of depression. In the endocrine model, evidence suggests the HPA axis is hyperactive in melancholic depression, and hypoactive in atypical depression. Atypical depression can be differentiated from melancholic depression via verbal fluency tests and psychomotor speed tests. Although both show impairment in several areas such as visuospatial memory and verbal fluency, melancholic patients tend to show more impairment than atypical depressed patients.
|
|
Simplified representation There is no widely accepted measure of what is a healthy level for sex desire. Some people want to have sex every day, or more than once a day; others once a year or not at all. However, a person who lacks a desire for sexual activity for some period of time may be experiencing a hypoactive sexual desire disorder or may be asexual. A sexual desire disorder is more common in women than in men, and women tend to exhibit less frequent and less intense sexual desires than men.
|
|
She moves into a hostel and experiences the freedom of big city life with her new friends Shazia and DJ Gurjar. She hides this information from Dolly, who finds Kajal's line of work indecent and unfit for women from good families. Meanwhile, Dolly struggles with hypoactive sexual desire disorder, leading to lack of intimacy with Amit and frustration. Dolly sets up a meeting with her estranged mother to understand whether her sexual difficulties are genetic, but her mother denies having any sexual problems and encourages Dolly to discover herself and find her own freedom.
|
|
Depression is linked with a hyperactive right hemisphere, with evidence of selective involvement in "processing negative emotions, pessimistic thoughts and unconstructive thinking styles", as well as vigilance, arousal and self-reflection, and a relatively hypoactive left hemisphere, "specifically involved in processing pleasurable experiences" and "relatively more involved in decision-making processes". Additionally, "left hemisphere lesions result in an omissive response bias or error pattern whereas right hemisphere lesions result in a commissive response bias or error pattern." The delusional misidentification syndromes, reduplicative paramnesia and Capgras delusion are also often the result of right hemisphere lesions.
|
|
Studies conducted in rats have indicated that their degree of sexual arousal is sensitive to reductions in testosterone. When testosterone-deprived rats were given medium levels of testosterone, their sexual behaviors (copulation, partner preference, etc.) resumed, but not when given low amounts of the same hormone. Therefore, these mammals may provide a model for studying clinical populations among humans suffering from sexual arousal deficits such as hypoactive sexual desire disorder. Every mammalian species examined demonstrated a marked increase in a male's testosterone level upon encountering a novel female.
|
|
Fabre-Kramer Pharmaceuticals is a pharmaceutical company that specializes in the development of psychotropic drugs. Products in their current development pipeline include gepirone and FKB01MD for major depression, gepirone and FKW00GA for generalized anxiety disorder, gepirone for hypoactive sexual desire disorder, FKF02SC for schizophrenia, and FKK01PD for Parkinson's disease. The company has also conducted clinical studies on a gepirone extended release formulation for major depression. In 2007, Fabre-Kramer Pharmaceuticals along with GlaxoSmithKline (GSK) received a 'not approvable' letter from the US Food and Drug Administration, for a gepirone extended release drug, an antidepressant treatment for adults.
|
|
For years, the New View Campaign challenged FDA approval of Intrinsa (2004) and Flibanserin (2010, 2015) for women's hypoactive sexual desire and female sexual dysfunction. With petition work, mainstream interviews and debates, public actions, and presentations at FDA hearings, Tiefer and the New View Campaign challenged the highly deceptive pharmaceutical public relations campaigns in 2004, 2010, and 2015 that pressured the FDA to approve Flibanserin. This effort spanned twelve years, from 2003 to 2015. In 2008, the New View Campaign expanded its work to examine female genital cosmetic surgery, a growing aspect of the medicalization of women's sexual lives.
|
|
Another drug that has been referred to as an NDDI in the medical literature is flibanserin, which is approved as a treatment for hypoactive sexual desire disorder in premenopausal women. Flibanserin disinhibits norepinephrine and dopamine release in the prefrontal cortex by activating 5-HT1A receptors in this area. Aside from agomelatine, fluoxetine, and flibanserin, as of present, no other drugs have been described as NDDIs in the medical literature, despite the fact that many other existing drugs possess effects consistent with those of the definition of an NDDI. In any case, more drugs labeled specifically as NDDIs may be seen in the future.
|
|
In the revision of the DSM-III, published in 1987 (DSM-III-R), ISD was subdivided into two categories: Hypoactive Sexual Desire Disorder and Sexual Aversion Disorder (SAD). The former is a lack of interest in sex and the latter is a phobic aversion to sex. In addition to this subdivision, one reason for the change is that the committee involved in revising the psychosexual disorders for the DSM-III-R thought that term "inhibited" suggests psychodynamic cause (i.e., that the conditions for sexual desire are present, but the person is, for some reason, inhibiting their own sexual interest).
|
|
The rs489693 polymorphism, in particular, sustained a statistically robust signal across three replication cohorts and demonstrated consistent recessive effects. This finding was replicated again by another research group in the following year. In accordance with the above, MC4 receptor agonists have garnered interest as potential treatments for obesity and insulin resistance, while MC4 receptor antagonists have attracted interest as potential treatments for cachexia. MC4 receptor agonists like bremelanotide (PT-141), PL-6983, and PF-00446687 are under investigation as powerful potential treatments for both female and male sexual dysfunction, including hypoactive sexual desire disorder and erectile dysfunction.
|
|
Bupropion is less likely than other antidepressants to cause sexual dysfunction. A range of studies demonstrate that bupropion not only produces fewer sexual side effects than other antidepressants, but can actually help to alleviate sexual dysfunction. According to a survey of psychiatrists, it is the drug of choice for the treatment of SSRI-induced sexual dysfunction, although this is not an indication approved by the U.S. Food and Drug Administration (FDA). There have also been several studies suggesting that bupropion can improve sexual function in women who are not depressed, if they have hypoactive sexual desire disorder (HSDD).
|
|
With animal models, there is a limitation to understanding sexual dysfunction and sexual medicine, as the results achieved can only mount to predictions. Identification and treatment of female sexual dysfunctions are also a challenge as women often encounter difficulty within multiple disorders and sexual phases. The various sexual phases that are encompassed within female sexual dysfunctions (FSD) include hypoactive sexual desire disorder (HSDD), female sexual arousal disorder (FSAD), female orgasmic disorder (FOD) and female sexual pain disorders (FPD). Because many of these domains overlap, it is difficult to identify the target of treatment and many limitations are placed in the approach for research.
|
|
There are various subtypes. HSDD can be general (general lack of sexual desire) or situational (still has sexual desire, but lacks sexual desire for current partner), and it can be acquired (HSDD started after a period of normal sexual functioning) or lifelong (the person has always had no/low sexual desire.) In the DSM-5, HSDD was split into male hypoactive sexual desire disorder and female sexual interest/arousal disorder. It was first included in the DSM-III under the name inhibited sexual desire disorder, but the name was changed in the DSM-III-R. Other terms used to describe the phenomenon include sexual aversion and sexual apathy.
|
|
However, when a person fails to be aroused in a situation that would normally produce arousal and the lack of arousal is persistent, it may be due to a sexual arousal disorder or hypoactive sexual desire disorder. There are many reasons why a person fails to be aroused, including a mental disorder, such as depression, drug use, or a medical or physical condition. The lack of sexual arousal may be due to a general lack of sexual desire or due to a lack of sexual desire for the current partner. A person may always have had no or low sexual desire or the lack of desire may have been acquired during the person's life.
|
|
Estrogens are responsible for the maintenance of collagen, elastic fibers, and vasoculature of the urogenital tract, all of which are important in maintaining vaginal structure and functional integrity; they are also important for maintaining vaginal pH and moisture levels, both of which aid in keeping the tissues lubricated and protected. Prolonged estrogen deficiency leads to atrophy, fibrosis, and reduced blood flow to the urogenital tract, which is what causes menopausal symptoms such as vaginal dryness and pain related to sexual activity and/or intercourse. It has been consistently demonstrated that women with lower sexual functioning have lower estradiol levels. Androgen therapy for hypoactive sexual desire disorder (HSDD) has a small benefit but its safety is not known.
|
|
Hypoactive sexual desire disorder (HSDD), hyposexuality or inhibited sexual desire (ISD) is considered a sexual dysfunction and is characterized as a lack or absence of sexual fantasies and desire for sexual activity, as judged by a clinician. For this to be regarded as a disorder, it must cause marked distress or interpersonal difficulties and not be better accounted for by another mental disorder, a drug (legal or illegal), or some other medical condition. A person with ISD will not start, or respond to their partner's desire for, sexual activity.University of Maryland, Medical Centre: Inhibited sexual desire HSDD affects approximately 10% of all pre-menopausal women in the United States, or about 6 million women.
|
|
Davis's work on schizophrenia has shown that oligodendroglia cells and myelin play roles in the disease's pathophysiologyMyelin and oligodendrocyte abnormalities in schizophrenia, Cambridge Journals and that dopamine – long thought to be merely hyperactive in a schizophrenic brain – is actually hypoactive in different regions.Schizophrenia, Bipolar May Share Cause, WebMD.com His paper, "Dopamine in schizophrenia—a review and reconceptualization" (American Journal of Psychiatry, 148-11: 1474–86, November 1991) is the third most-cited paper on schizophrenia research in its decade.Science Watch While studies have shown that individuals born in winter months are disproportionately likely to develop schizophrenia, Davis participated in a 2006 study that demonstrated that this disproportionality also exists in tropical regions, ruling out cold weather as the cause.
|
|
Its roles in the cell cycle and apoptosis help cells maintain an immature state, and its expression wanes as cells begin to differentiate. Bmi-1 and Myc were found to be partners within the cell nucleus. Bmi-1 and c-Myc seem to function in tandem in multiple ways. Studies have found that together c-Myc and Bmi-1 possess the ability to alter tumor suppressor genes. Hypoactive c-Myc was shown to alter p16 via Bmi-1, while hyperactive c-Myc was capable of altering the p16 promoter itself [28]. Normally, p16 functions to prevent cells from progressing through the G1 phase to the S phase of the cell cycle too quickly.
|
|
Female sexual arousal disorder (FSAD) is a disorder characterized by a persistent or recurrent inability to attain sexual arousal or to maintain arousal until the completion of a sexual activity. The diagnosis can also refer to an inadequate lubrication-swelling response normally present during arousal and sexual activity. The condition should be distinguished from a general loss of interest in sexual activity and from other sexual dysfunctions, such as the orgasmic disorder (anorgasmia) and hypoactive sexual desire disorder, which is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time. Although female sexual dysfunction is currently a contested diagnostic, it has become more common in recent years to use testosterone-based drugs off-label to treat FSAD.
|
|
In that year, sex therapists Helen Singer Kaplan and Harold Lief independently of each other proposed creating a specific category for people with low or no sexual desire. Lief named it "inhibited sexual desire", and Kaplan named it "hypoactive sexual desire". The primary motivation for this was that previous models for sex therapy assumed certain levels of sexual interest in one's partner and that problems were only caused by abnormal functioning/non-functioning of the genitals or performance anxiety but that therapies based on those problems were ineffective for people who did not sexually desire their partner. The following year, 1978, Lief and Kaplan together made a proposal to the APA's taskforce for sexual disorders for the DSM III, of which Kaplan and Lief were both members.
|
|
Australian journalist Ray Moynihan has argued that the pharmaceutical industry engages in disease mongering to enlarge its profits, and that it harms citizens. His use of osteoporosis as an example of a "made up" disease in this article prompted an angry retort from the president of the British National Osteoporosis Society, stating that the article was insulting to people with osteoporosis and vastly understated the risk of disabling fractures associated with the disorder. Moynihan published a satire of disease mongering in the 2006 April Fool's Day issue of BMJ titled "Scientists find new disease: motivational deficiency disorder". Other conditions which have been cited as examples of disease mongering include restless leg syndrome, testosterone deficiency, erectile dysfunction, hypoactive sexual desire disorder.
|
|
There is significant debate over whether or not asexuality is a sexual orientation. It has been compared and equated with hypoactive sexual desire disorder (HSDD), in that both imply a general lack of sexual attraction to anyone; HSDD has been used to medicalize asexuality, but asexuality is generally not considered a disorder or a sexual dysfunction (such as anorgasmia, anhedonia, etc.), because it does not necessarily define someone as having a medical problem or problems relating to others socially. Unlike people with HSDD, asexual people normally do not experience "marked distress" and "interpersonal difficulty" concerning feelings about their sexuality, or generally a lack of sexual arousal; asexuality is considered the lack or absence of sexual attraction as a life-enduring characteristic. One study found that, compared to HSDD subjects, asexuals reported lower levels of sexual desire, sexual experience, sex-related distress and depressive symptoms.
|
|
Testosterone therapy is effective in the short-term for the treatment of hypoactive sexual desire disorder (HSDD) in women. However, its long-term safety is unclear. Because of a lack data to support its efficacy and safety, the Endocrine Society recommends against the routine use of testosterone in women to treat low androgen levels due to hypopituitarism, adrenal insufficiency, surgical removal of the ovaries, high-dose corticosteroid therapy, or other causes. Similarly, because of a lack of data to support its efficacy and safety, the Endocrine Society recommends against the use of testosterone in women to improve general well-being, to treat infertility, sexual dysfunction due to causes other than HSDD, or to improve cognitive, cardiovascular, metabolic, and/or bone health. A 2014 systematic review and meta-analysis of 35 studies consisting of over 5,000 postmenopausal women with normal adrenal gland function found that testosterone therapy was associated with significant improvement in a variety of domains of sexual function.
|
|
In the DSM-5, male hypoactive sexual desire disorder is characterized by "persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity", as judged by a clinician with consideration for the patient's age and cultural context. Female sexual interest/arousal disorder is defined as a "lack of, or significantly reduced, sexual interest/arousal", manifesting as at least three of the following symptoms: no or little interest in sexual activity, no or few sexual thoughts, no or few attempts to initiate sexual activity or respond to partner's initiation, no or little sexual pleasure/excitement in 75–100% of sexual experiences, no or little sexual interest in internal or external erotic stimuli, and no or few genital/nongenital sensations in 75–100% of sexual experiences. For both diagnoses, symptoms must persist for at least six months, cause clinically significant distress, and not be better explained by another condition. Simply having lower desire than one's partner is not sufficient for a diagnosis.
|
|
The highest rates of delirium (often 50% to 75% of people) is seen among those who are critically ill in the intensive care unit (ICU) As a result, this was referred to as "ICU psychosis" or "ICU syndrome", terms largely abandoned for the more widely accepted term ICU delirium. Since the advent of validated and easy-to-implement delirium instruments for ICU patients such as the Confusion Assessment Method for the ICU (CAM-ICU) and the Intensive Care Delirium Screening Checkllist (IC-DSC)., of the hundreds of thousands of ICU patients who develop delirium in ICUs every year, it has been recognized that most of them belong to the hypoactive variety, which is easily missed and invisible to the managing teams unless actively monitored using such instruments. The causes of delirium in such patients depend on the underlying illnesses, new problems like sepsis and low oxygen levels, and the sedative and pain medicines that are nearly universally given to all ICU patients.
|
|
In her 2013 article, "Producing Facts: Empirical Asexuality and the Scientific Study of Sex", Przybylo distinguishes between two different stages of asexual research: that of the late 1970s to the early 1990s, which often included a very limited understanding of asexuality, and the more recent revisiting of the subject which she says began with Bogaert's 2004 study and has popularized the subject and made it more "culturally visible". In this article, Przybylo once again asserts the understanding of asexuality as a cultural phenomenon, and continues to be critical of its scientific study. CJ DeLuzio Chasin states in Reconsidering Asexuality and Its Radical Potential that academic research on asexuality "has positioned asexuality in line with essentialist discourses of sexual orientation" which is troublesome as it creates a binary between asexuals and persons who have been subjected to psychiatric intervention for disorders such as Hypoactive Sexual Desire Disorder. Chasin says that this binary implies that all asexuals experience a lifelong (hence, enduring) lack of sexual attraction, that all non-asexuals who experience a lack of sexual desire experience distress over it, and that it pathologizes asexuals who do experience such distress.
|
|