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了解女性性欲减退障碍(HSDD):病因、诊断与治疗

Understanding Hypoactive Sexual Desire Disorder (HSDD) in Women: Etiology, Diagnosis, and Treatment.

作者信息

Ronghe Vaishnavi, Pannase Krutika, Gomase Kavita P, Mahakalkar Manjusha G

机构信息

Obstetrics and Gynaecology, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Obstetrics and Gynaecology Nursing, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2023 Nov 30;15(11):e49690. doi: 10.7759/cureus.49690. eCollection 2023 Nov.

Abstract

Hypoactive Sexual Desire Disorder (HSDD) is a complex and multifaceted condition that significantly impacts the sexual well-being and overall quality of life of women. This comprehensive review aims to provide a holistic understanding of HSDD by exploring its etiology, diagnostic criteria, treatment approaches, and broader societal implications. The review delves into the intricate interplay of biological factors, including hormonal changes and neurotransmitter imbalances, that contribute to HSDD. Psychological factors, such as relationship issues, body image, and stress, are examined with sociocultural factors like societal norms, cultural influences, and media portrayals of sexuality. Diagnostic criteria and assessment methods, including The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, and self-report questionnaires, are explored to facilitate accurate identification of HSDD and differentiation from other sexual disorders. The impact of HSDD on women's quality of life and relationships is examined, highlighting the emotional strain and interpersonal challenges associated with the disorder. Societal and personal consequences of untreated HSDD underscore the need for increased awareness and support. Treatment approaches encompass non-pharmacological interventions such as cognitive-behavioral therapy, sex therapy, and couples therapy and pharmacological interventions like hormone therapy and selective serotonin reuptake inhibitors. Novel treatments like bremelanotide, flibanserin, and integrative strategies combining psychotherapy and lifestyle changes are discussed. Challenges and controversies surrounding HSDD, including the lack of consensus on diagnostic criteria, debates about the medicalization of sexuality, ethical concerns regarding pharmaceutical interventions, and cultural considerations, are addressed. Future directions in research, including advances in neurobiological understanding, personalized medicine, long-term treatment studies, and destigmatization initiatives, offer promising pathways for enhancing the management of HSDD.

摘要

性欲减退障碍(HSDD)是一种复杂且多方面的病症,会对女性的性健康和整体生活质量产生重大影响。这篇综述旨在通过探讨其病因、诊断标准、治疗方法以及更广泛的社会影响,全面了解HSDD。该综述深入研究了导致HSDD的生物因素之间复杂的相互作用,包括激素变化和神经递质失衡。心理因素,如关系问题、身体形象和压力,以及社会文化因素,如社会规范、文化影响和媒体对性的描绘,都在研究范围内。探讨了诊断标准和评估方法,包括《精神疾病诊断与统计手册》第五版标准和自我报告问卷,以促进对HSDD的准确识别以及与其他性障碍的区分。研究了HSDD对女性生活质量和关系的影响,突出了与该病症相关的情感压力和人际挑战。未经治疗的HSDD的社会和个人后果凸显了提高认识和提供支持的必要性。治疗方法包括非药物干预,如认知行为疗法、性治疗和夫妻治疗,以及药物干预,如激素疗法和选择性5-羟色胺再摄取抑制剂。还讨论了诸如布雷美拉诺肽、氟班色林等新型治疗方法以及结合心理治疗和生活方式改变的综合策略。解决了围绕HSDD的挑战和争议,包括诊断标准缺乏共识、关于性医学化的辩论、药物干预的伦理问题以及文化考量。研究的未来方向,包括神经生物学理解的进展、个性化医疗、长期治疗研究和消除污名化倡议,为加强HSDD的管理提供了有希望的途径。

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