{"id":446,"date":"2017-03-17T03:55:34","date_gmt":"2017-03-17T08:55:34","guid":{"rendered":"http:\/\/www.creative-peptides.com\/blog\/?p=446"},"modified":"2017-03-17T03:55:34","modified_gmt":"2017-03-17T08:55:34","slug":"diagnosis-and-management-of-female-sexual-arousal-disorder","status":"publish","type":"post","link":"https:\/\/www.creative-peptides.com\/blog\/diagnosis-and-management-of-female-sexual-arousal-disorder\/","title":{"rendered":"Diagnosis and Management of Female Sexual Arousal Disorder"},"content":{"rendered":"

Although female sexual arousal disorder\u00a0(FSAD) is prevalent, it is often not well defined\u00a0or understood. The current definition of FSAD\u00a0discussed below is based on the Diagnostic and<\/i><\/em>\u00a0<\/i><\/em>Statistical Manual of Mental Disorders<\/i><\/em>, Fourth<\/i><\/em>\u00a0<\/i><\/em>Edition Revised <\/i><\/em>(DSM-IV-TR), which includes a\u00a0requirement that the woman has concomitant distress. According to the DSM-IV , the diagnostic\u00a0criteria to define sexual arousal disorder are (1)\u00a0persistent or recurrent inability to attain, or to\u00a0maintain until completion of the sexual activity,\u00a0an adequate lubrication-swelling response of sexual excitement, (2) the disturbance causes marked\u00a0distress or interpersonal difficulty, and (3) the\u00a0sexual dysfunction is not better accounted for by\u00a0another axis I disorder (except another sexual\u00a0dysfunction) and is not due exclusively to the
\ndirect physiological effects of a substance (e.g., a\u00a0drug of abuse, a medication) or a general medical\u00a0condition. Oftentimes medications such\u00a0as selective serotonin reuptake inhibitors (SSRIs)\u00a0can lead to such sexual dysfunctions including\u00a0arousal and desire dysfunction. Thus, the DSM\u00a0definition of arousal disorder may be limited in\u00a0its ability to appropriately classify some of these\u00a0patients.<\/p>\n

Nonhormonal<\/b><\/strong>\u00a0<\/b><\/strong>Supplementation<\/b><\/strong><\/p>\n

Sexual motivation is encouraged, sustained, and\u00a0ended by a number of central nervous system\u00a0neurotransmitter and receptor changes induced, in\u00a0part, by the action of the central neurotransmitter\u00a0dopamine. The activation of dopamine receptors\u00a0may be a key intermediary in the stimulation of\u00a0incentive sexual motivation and sexual reward.\u00a0These neurotransmitters and receptor changes in\u00a0turn activate central sexual arousal and desire.\u00a0Contemporary animal research reveals that dopamine neurotransmitter systems may play a critical intermediary role in the central regulation of\u00a0sexual arousal and excitation, mood, and\u00a0incentive- related sexual behavior. Nonhormonal\u00a0neuropeptides like oxytocin and prolactin have\u00a0also been utilized in this clinical setting with\u00a0good success.<\/p>\n

Vasoactive agents including phosphodiesterase inhibitors (PDEi\u2019s) have been investigated in\u00a0several studies for treatment of FSAD. In a small\u00a0proportion of the studies, women with FSAD\u00a0endorsed a beneficial effect on arousal, while in\u00a0most of the studies, vasoactive agents had no\u00a0effect when compared with placebo. Smaller\u00a0studies in populations with other medical conditions have shown more consistent effects. As\u00a0such, PDEi\u2019s may be beneficial in specific groups\u00a0of women with FSAD.<\/p>\n

Bupropion , which is a noradrenaline and dopamine reuptake inhibitor with nicotinic antagonist\u00a0properties originally marketed as an antidepressant, may have a beneficial effect on women with\u00a0sexual arousal disorder. In one placebocontrolled trial, bupropion produced an\u00a0increase in desire and frequency of sexual activity\u00a0when compared with placebo. Segraves et al.\u00a0investigated the role of sustained release bupropion in a randomized, double-blind, placebo-controlled, multiple-site escalating-dose 112-day\u00a0trial. Outcomes were measured by investigatorrating and self- administered questionnaires. The\u00a0changes in sexual functioning questionnaire\u00a0(CSFQ) indicated that bupropion had significant\u00a0effects on increasing measures of sexual arousal,\u00a0orgasm, and sexual satisfaction. Traditional antidepressant dosing starts at 150 mg twice a day;\u00a0however, low-dose bupropion at 75 mg twice a\u00a0day can achieve an optimal improvement in sexual arousal potential.<\/p>\n

Other dopamine agonists used are cabergoline\u00a0administered at 0.5 mg up to three times per week\u00a0and ropinirole 0.25 mg administered daily.\u00a0Oxytocin lozenges, linked to improved arousal\u00a0and desire, are administered at 250 IU sublingually 30 min to 1 h before sexual activity.\u00a0Research with oxytocin has shown marked\u00a0improvement in a number of components of sexual function, including arousal and orgasm.\u00a0Lastly, amphetamine salts including dextroamphetamine\/amphetamine (Adderall) and other\u00a0drugs used to treat attention deficit disorder have\u00a0been increasingly useful in helping women to\u00a0concentrate and thus improving arousal.<\/p>\n

Lastly, flibanserin and bremelanotide , two\u00a0drugs in development, may show promise for the\u00a0future of FSAD treatments. Flibanserin is a nonhormonal treatment for premenopausal women\u00a0with HSDD. Flibanserin is a 5-HT1A\u00a0receptor agonist and 5-HT2A receptor antagonist\u00a0that was initially investigated as an antidepressant. Preclinical evidence suggested that\u00a0flibanserin targets the above receptors preferentially in selective brain areas, restores a balance\u00a0between inhibitory and excitatory effects, and may\u00a0show benefit in the treatment of FSAD.<\/p>\n

Bremelanotide<\/a> is a drug under development\u00a0for female sexual dysfunction, hemorrhagic\u00a0shock, and reperfusion injury. It functions by\u00a0activating the melanocortin receptors MC1R\u00a0and MC4R, to modulate inflammation and limit\u00a0ischemia. Bremelanotide was originally\u00a0tested for intranasal administration in treating\u00a0female sexual dysfunction, but this application\u00a0was temporarily discontinued in 2008 after concerns were raised over adverse side effects\u00a0including elevated blood pressure. As of\u00a0December 2014, the company is conducting a\u00a0human phase 3 study using a subcutaneous drug\u00a0delivery system that appears to have little effect\u00a0on blood pressure.<\/p>\n

 <\/p>\n

Reference:<\/h4>\n

Seth D. Cohen and Irwin Goldstein\u00a0Springer Science+Business Media New York 2016<\/p>\n","protected":false},"excerpt":{"rendered":"

Although female sexual arousal disorder\u00a0(FSAD) is prevalent, it is often not well defined\u00a0or understood. The current definition of FSAD\u00a0discussed below is based on the Diagnostic and\u00a0Statistical Manual of Mental Disorders, …<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[75],"tags":[85,86],"_links":{"self":[{"href":"https:\/\/www.creative-peptides.com\/blog\/wp-json\/wp\/v2\/posts\/446"}],"collection":[{"href":"https:\/\/www.creative-peptides.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.creative-peptides.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.creative-peptides.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.creative-peptides.com\/blog\/wp-json\/wp\/v2\/comments?post=446"}],"version-history":[{"count":1,"href":"https:\/\/www.creative-peptides.com\/blog\/wp-json\/wp\/v2\/posts\/446\/revisions"}],"predecessor-version":[{"id":447,"href":"https:\/\/www.creative-peptides.com\/blog\/wp-json\/wp\/v2\/posts\/446\/revisions\/447"}],"wp:attachment":[{"href":"https:\/\/www.creative-peptides.com\/blog\/wp-json\/wp\/v2\/media?parent=446"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.creative-peptides.com\/blog\/wp-json\/wp\/v2\/categories?post=446"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.creative-peptides.com\/blog\/wp-json\/wp\/v2\/tags?post=446"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}