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Previous Volume 354:1497-1506 April 6, 2006 Number 14 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.

A 46-year-old woman, married for 16 years, reports having had a low level of sexual desire and minimal sexual arousal during sexual activity for the past 10 years. Sexual thoughts, fantasies, and orgasms are all extremely rare. Lubrication is sufficient to allow painless intercourse. She and her husband have an eight-year-old son who was born after in vitro fertilization for unexplained infertility. . . . [Full Text of this Article]

The Clinical Problem

Factors Influencing Desire and Arousal

            Physiologic Factors

            Other Factors

Strategies and Evidence

Evaluation

Management

            Psychological Interventions

            Pharmacologic Interventions

            Nonhormonal Therapies

            Hormonal Therapies

            Androgen Therapies

            Dehydroepiandrosterone

            Estrogen

            Sexual Dysfunction Associated with Antidepressants

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the Departments of Psychiatry and Obstetrics and Gynaecology, University of British Columbia; and the British Columbia Centre for Sexual Medicine, Vancouver General Hospital, Vancouver, B.C., Canada.

Address reprint requests to Dr. Basson at the B.C. Centre for Sexual Medicine, Vancouver General Hospital, 855 W. 12th Ave., Vancouver, BC V5Z 1M9, Canada, or at sexmed@interchange.ubc.ca.

This article has been cited by other articles:

• West, S. L., D'Aloisio, A. A., Agans, R. P., Kalsbeek, W. D., Borisov, N. N., Thorp, J. M. (2008). Prevalence of Low Sexual Desire and Hypoactive Sexual Desire Disorder in a Nationally Representative Sample of US Women. Arch Intern Med 168: 1441-1449 [Abstract] [Full Text]  
• Basson, R. (2008). Testosterone Supplementation to Improve Women's Sexual Satisfaction: Complexities and Unknowns. ANN INTERN MED 148: 620-621 [Full Text]  
• Ganz, P. A., Greendale, G. A. (2007). Female Sexual Desire--Beyond Testosterone. JNCI J Natl Cancer Inst 99: 659-661 [Full Text]  
• Gastaud, F., Bouvattier, C., Duranteau, L., Brauner, R., Thibaud, E., Kutten, F., Bougneres, P. (2007). Impaired Sexual and Reproductive Outcomes in Women with Classical Forms of Congenital Adrenal Hyperplasia. J. Clin. Endocrinol. Metab. 92: 1391-1396 [Abstract] [Full Text]  
• Potter, J. E. (2007). A 60-Year-Old Woman With Sexual Difficulties. JAMA 297: 620-633 [Abstract] [Full Text]  
• Laine, H., Jones, K. P. (2007). Hypoactive Sexual Dysfunction in a Young Woman. Obstet Gynecol 109: 415-418 [Full Text]  
• Wierman, M. E., Basson, R., Davis, S. R., Khosla, S., Miller, K. K., Rosner, W., Santoro, N. (2006). Androgen Therapy in Women: An Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 91: 3697-3710 [Abstract] [Full Text]