The New England Journal of MedicineSexual Dysfunction in Women

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Sexual dysfunction in women is a common and complex issue that significantly impacts quality of life. This comprehensive review explores the classification, prevalence, contributing factors, and management strategies for female sexual dysfunction. It emphasizes the importance of a holistic approach to assessment and treatment, considering biological, psychological, and social factors.

Key Points:

• The ICD-11 has revised the classification of sexual dysfunctions, recognizing the interplay of biologic, psychological, and social factors.
• Prevalence of sexual dysfunction varies with age, with hypoactive sexual desire dysfunction peaking during midlife.
• Common contributing factors include hormonal changes, chronic diseases, medications, and psychosocial issues.
• Assessment should include a thorough history, physical examination, and targeted investigations when clinically indicated.
• Management options range from lifestyle modifications and psychosocial interventions to pharmacotherapy, including hormone therapy and FDA-approved medications for premenopausal women with hypoactive sexual desire dysfunction.
• Transdermal testosterone therapy shows promise for postmenopausal women with hypoactive sexual desire dysfunction, but long-term safety data are lacking.
• There is a need for more effective pharmacotherapies for arousal and orgasm dysfunction.

HCN Medical Memo
Addressing sexual dysfunction in women requires a comprehensive approach that considers biological, psychological, and social factors. Although pharmacological options are available, individualized treatment plans incorporating lifestyle modifications and psychosocial interventions often yield the best outcomes.

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