Bienestar sexual después de la menopausia, Conclusión

Una función sexual positiva en la mediana edad puede mejorar la calidad personal y de la relación, mejorar la longevidad y mejorar la CV.

Sin embargo, muchas mujeres sufren de bajo deseo, excitación y disfunción orgásmica con o sin dolor sexual debido a AVV/SGUM después de la menopausia. Tanto las mujeres como los médicos son reacios a sacar a luz los problemas sexuales, por lo que a menudo no se tratan, lo que da como resultado efectos perjudiciales en la relación a pesar de los tratamientos disponibles seguros y efectivos.

Se espera que este breve manuscrito de «cómo hacerlo» pueda ayudar a los profesionales que atienden a mujeres menopáusicas a abrir el diálogo y proporcionar o facilitar un tratamiento adecuado.

Conflicto de intereses

J. A. Simon ha servido (en el último año) o actualmente sirve como asesor para o en comités de consultoría de AbbVie, Inc. (North Chicago, IL), Allergan, Plc (Parsippany, NJ), AMAG Pharmaceuticals, Inc. (Waltham, MA), Amgen (Thousand Oaks, CA), Ascend Therapeutics (Herndon, VA), Bayer HealthCare Pharmaceuticals Inc. (Whippany, NJ), CEEK Enterprises, LLC. (Cambridge, MA), Covance Inc., (Princeton, NJ), Millendo Therapeutics, Inc. (Ann Arbor, MI), Mitsubishi Tanabe Pharma Development America, Inc. (Jersey City, New Jersey), ObsEva SA (Geneva, Switzerland), Radius Health, Inc. (Waltham, MA), Sanofi S.A. (Paris, France), Sebela Pharmaceuticals, Inc. (Roswell, GA), Shionogi Inc. (Florham Park, NJ), Symbiotec Pharmalab (Indore, India), Therapeutics MD (Boca Raton, FL), & Valeant Pharmaceuticals (Laval, Canada). Ha servido (en el último año) o actualmente como conferenciante de AMAG Pharmaceuticals, Inc. (Waltham, MA), Duchesnay USA (Rosemont, PA), Novo Nordisk (Bagsvrerd, Denmark), Shionogi Inc. (Florham Park, NJ), & Valeant Pharmaceuticals (Laval, Canadá).

En el último año ha recibido o está recibiendo actualmente apoyo o asignaciones para investigación de AbbVie, Inc. (North Chicago, IL), Allergan, Plc (Parsippany, NJ), Agile Therapeutics (Princeton, NJ), Bayer Healthcare LLC. (Tarrytown, NY), Dornier MedTech (Munich, Germany), Endoceutics, Inc. (Quebec, Canada), GTx, Inc. (Memphis, TN), Ipsen (Paris, France), Myovant Sciences (Basel, Switzerland), New England Research Institute, Inc. (Watertown, MA), ObsEva SA (Geneva, Switzerland), Palatin Technologies (Cranbury, NJ), Symbio Research, Inc. (Port Jefferson, NY), Therapeutics MD (Boca Raton, FL), & Tissue Genesis (Honolulu, HI). El Dr. Simon es accionista de (compra directa) Sermonix Pharmaceuticals (Columbus, OH).

S. R. Davis ha recibido honorarios de Abbott Australia, Pfizer Pharmaceuticals & Besins Healthcare y apoyo para investigación de Lawley Pharmaceuticals. S. E. Althof es un investigador o miembro del consejo consultor de AMAG/Palatin, Clinical Outcomes Solutions, Endoceutics, Ixchelsis, Promescent, Strategic Science Technologies & Sprout/Valeant.

P. Chedraui no tiene conflictos de interés que declarar.

A. H. Clayton ha recibido asignaciones de: Axsome, Endoceutics, Inc., Janssen, Palatin Technologies, Sage Therapeutics, & Takeda. Es consultor o miembro del consejo consultor científico de Alkermes, AMAG Pharmaceuticals, Inc., Fabre-Kramer, Ivix, Palatin Technologies, S1 Biopharma, Sprout Pharmaceuticals, Valeant Pharmaceuticals, & Takeda. Ha recibido regalías/copyright de: Ballantine Books/Random House, Changes in Sexual Functioning Questionnaire, & Guilford Publications. Comparte acciones/stock restringido de: Euthymics & S1 Biopharma.

S. A. Kingsberg es consultor de, miembro del consejo consultor científico o investigador clínico de AMAG, Endoceutics, TherapeuticsMD, Pfizer, Palatin Technologies, Emotional Brain, Valeant Pharmaceuticals, Sermonix Pharmaceuticals, Duchesney, Dare, IVIX, GTx, Materna, Strategic Scientific Solutions (SST), Sprout Pharmaceuticals, & Lupin.

R. E. Nappi ha recibido honorarios como conferenciante para Novo Nordisk, Bayer Healthcare AG, Pfizer Inc., MSD, TEVA Women’s Health Inc., Shionogi Limited, Gedeon Richter, Exceltis & Endoceutics. Es miembro de los consejos consultores científicos de Bayer Healthcare AG, MSD, TEVA Women’s Health Inc., Shionogi Limited, & Gedeon Richter. Ha recibido asignaciones de investigación de Shionogi Limited & Gedeon Richter.

S. J. Parish es miembro de los consejos consultores científicos de Allergen, AMAG, & Duchesnay Pharmaceuticals. Ha recibido honorarios como conferenciante de AMAG & Valeant Pharmaceuticals y actuado como asesor para Strategic Science Technologies. Ha recibido apoyo por escribir, sin compensación de Allergen & Pfizer Pharmaceuticals.

W. Wolfman ha estado en consejos consultores de Pfizer & Acerus. Ha recibido honorarios como conferenciante de Pfizer, Merck & Searchlight. Ha recibido asignación de Pfizer para entrenamiento e investigación.

Fuente de financiamiento

Este documento fue apoyado por la Sociedad Internacional de Menopausia. S. R. Davis es un investigador principal Fellow Senior NHMRC (Asignación núm. 1135843).

Referencias

• 1. Fooladi E, Bell RJ, Whittaker AM, Davis SR. Women’s expectations and experiences of hormone treatment for sexual dysfunction. Climacteric 2014; 17:674-81.
• 2. Tan HM, Marumo K, Yang DY, Hwang TI, Ong ML. Sex among Asian men and women the Global Better Sex Survey in Asia. Int J Urol. 2009; 16:507-14.
• 3. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, USA: American Psychiatric Publishing. 2013.
• 4. McCabe MP, Sharlip ID, Atalla E, et al. Definitions of sexual dysfunctions in women and men: a Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015. J Sex Med. 2016; 13:135-43.
• 5. Reed GM, Drescher J, Krueger RB, et al. Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations. World Psychiatry. 2016; 15:205-21.
• 6. Simon JA, Lukas VA. Distressing sexual function at midlife: unmet needs, practical diagnoses, and available treatments. Obstet Gynecol. 2017; 130:889-905.
• 7. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington DC: American Psychiatric Press; 1994.
• 8. Parish SJ, Goldstein AT, Goldstein SW, et al. Toward a more evidence-based nosology and nomenclature for female sexual dysfunctions. Part II. J Sex Med. 2016; 13:1888-906.
• 9. Parish SJ, Hahn SR. Hypoactive sexual desire disorder: a review of epidemiology, biopsychology, diagnosis, and treatment. Sex Med Rev. 2016; 4:103-20.
• 10. Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol. 2008; 112:970-8.

Otras Referencias

• 11. Worsley R, Bell RJ, Gartoulla P, Davis SR. Prevalence and predictors of low sexual desire, sexually related personal distress, and hypoactive sexual desire dysfunction in a community-based sample of midlife women.J Sex Med. 2017;14:675-86.
• 12. Zeleke BM, Bell RJ, Billah B, Davis SR. Hypoactive sexual desire dysfunction in community-dwelling older women. Menopause. 2017; 24:391-9.
• 13. Sidi H, Puteh SE, Abdullah N, Midin M. The prevalence of sexual dysfunction and potential risk factors that may impair sexual function in Malaysian women. J Sex Med. 2007; 4:311-21.
• 14. Tungphaisal S, Chandeying V, Sutthijumroon S, Krisanapan O, Udomratn P. Postmenopausal sexuality in Thai women. Asia Oceania J Obstet Gynaecol. 1991; 17:143-6.
• 15. Parish SJ, Nappi RE, Krychman ML, et al. Impact of vulvovaginal health on postmenopausal women: a review of surveys on symptoms of vulvovaginal atrophy. Int J Women Health. 2013; 5:437-47.
• 16. Nappi RE, Kokot-Kierepa M. Vaginal Health: Insights, Views & Attitudes (VIVA) – results from an international survey. Climacteric. 2012; 15:36-44.
• 17. Palacios S, Nappi RE, Bruyniks N, Particco M, Panay N; EVES Study Investigators. The European Vulvovaginal Epidemiological Survey (EVES): prevalence, symptoms and impact of vulvovaginal atrophy of menopause. Climacteric. 2018; 21:286-91.
• 18. Chua Y, Limpaphayom KK, Cheng B, et al. Genitourinary syndrome of menopause in five Asian countries: results from the Pan- Asian REVIVE survey. Climacteric. 2017;20: 367-73.
• 19. Lindau ST, Schumm LP, Laumann EO, Levinson W, O’Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007; 357:762-74.
• 20. Davis SR, Davison SL, Donath S, Bell RJ. Circulating androgen levels and self-reported sexual function in women. JAMA. 2005;294: 91-6.

Bibliografía

• 21. Wahlin-Jacobsen S, Pedersen AT, Kristensen E, et al. Is there a correlation between androgens and sexual desire in women? J Sex Med. 2015; 12:358-73.
• 22. Nappi RE, Cucinella L, Martella S, Rossi M, Tiranini L, Martini E. Female sexual dysfunction (FSD): prevalence and impact on quality of life (QoL). Maturitas. 2016; 94:87-91.
• 23. Dennerstein L, Dudley E, Burger H. Are changes in sexual functioning during midlife due to aging or menopause? Fertil Steril. 2001; 76:456-60.
• 24. Hayes R, Dennerstein L. The impact of aging on sexual function and sexual dysfunction in women: a review of population-based studies. J Sex Med. 2005; 2:317-30.
• 25. Hawton K, Gath D, Day A. Sexual function in a community sample of middle-aged women with partners: effects of age, marital, socioeconomic, psychiatric, gynecological, and menopausal factors. Arch Sex Behav. 1994; 23:375-95.
• 26. Avis NE, Assmann SF, Kravitz HM, Ganz PA, Ory M. Quality of life in diverse groups of midlife women: assessing the influence of menopause, health status and psychosocial and demographic factors. Qual Life Res. 2004; 13:933-46.
• 27. Blumel JE, Chedraui P, Baron G, et al. Sexual dysfunction in middle-aged women: a multicenter Latin American study using the Female Sexual Function Index. Menopause. 2009; 16:1139-48.
• 28. Chedraui P, Perez-Lopez FR, San Miguel G, Avila C. Assessment of sexuality among middle-aged women using the Female Sexual Function Index. Climacteric. 2009; 12:213-21.
• 29. Chedraui P, Perez-Lopez FR, Mezones-Holguin E, San Miguel G, Avila C, Collaborative Group for Research of the Climacteric in Latin America. Assessing predictors of sexual function in midaged sexually active women. Maturitas. 2011; 68:387-90.

Otras Bibliografías

• 30. Thomas HN, Thurston RC. A biopsychosocial approach to women’s sexual function and dysfunction at midlife: A narrative review. Maturitas. 2016; 87:49-60.
• 31. Bancroft J, Loftus J, Long JS. Distress about sex: a national survey of women in heterosexual relationships. Arch Sex Behav. 2003; 32:193-208.
• 32. Fernandez-Alonso AM, Alcaide-Torres J, Fernandez-Alonso IM, Chedraui P, Perez-Lopez FR. Application of the 21-item Vulvovaginal Symptoms Questionnaire in postmenopausal Spanish women. Menopause. 2017; 24:1295-301.
• 33. Levine KB, Williams RE, Hartmann KE. Vulvovaginal atrophy is strongly associated with female sexual dysfunction among sexually active postmenopausal women. Menopause. 2008; 15:661-6.
• 34. Leon P, Chedraui P, Hidalgo L, Ortiz F. Perceptions and attitudes toward the menopause among middle aged women from Guayaquil, Ecuador. Maturitas. 2007; 57:233-8.
• 35. Davison SL, Bell RJ, LaChina M, Holden SL, Davis SR. The relationship between selfreported sexual satisfaction and general wellbeing in women. J Sex Med. 2009; 6:2690-7.
• 36. Biddle AK, West SL, D’Aloisio AA, Wheeler SB, Borisov NN, Thorp J. Hypoactive sexual desire disorder in postmenopausal women: quality of life and health burden. Value Health. 2009; 12:763-72.
• 37. Nappi RE, Verde JB, Polatti F, Genazzani AR, Zara C. Self-reported sexual symptoms in women attending menopause clinics. Gynecol Obstet Invest. 2002; 53:181-7.
• 38. Nappi RE, Albani F, Santamaria V, et al. Hormonal and psycho-relational aspects of sexual function during menopausal transition and at early menopause. Maturitas. 2010; 67:78-83.
• 39. Gallicchio L, Schilling C, Tomic D, Miller SR, Zacur H, Flaws JA. Correlates of sexual functioning among mid-life women. Climacteric. 2007; 10:132-42.

Fuentes 

• 40. Avis NE, Colvin A, Karlamangla AS, et al. Change in sexual functioning over the menopausal transition: results from the Study of Women’s Health Across the Nation. Menopause. 2017; 24:379-90.
• 41. Davis SR, Castelo-Branco C, Chedraui P, et al.Understanding weight gain at menopause. Climacteric. 2012; 15:419-29.
• 42. Nackers LM, Appelhans BM, Segawa E, Janssen I, Dugan SA, Kravitz HM. Associations between body mass index and sexual functioning in midlife women: The Study of Women’s Health Across the Nation. Menopause 2015; 22:1175-81.
• 43. Jackson KL, Janssen I, Appelhans BM, et al. Body image satisfaction and depression in midlife women: The Study of Women’s Health Across the Nation (SWAN). Arch Womens Ment Health. 2014; 17:177-87.
• 44. Nappi RE, Palacios S. Impact of vulvovaginal atrophy on sexual health and quality of life at postmenopause. Climacteric. 2014; 17:3-9.
• 45. Portman DJ, Gass ML, Vulvovaginal Atrophy Terminology Consensus Conference Panel. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and The North American Menopause Society. Climacteric. 2014; 17:557-63.
• 46. Nappi RE, Kingsberg S, Maamari R, Simon J. The CLOSER (CLarifying Vaginal Atrophy’s Impact On SEx and Relationships) survey: implications of vaginal discomfort in posmenopausal women and in male partners. J Sex Med. 2013; 10:2232-41.
• 47. Nappi RE, Palacios S, Panay N, Particco M, Krychman ML. Vulvar and vaginal atrophy in four European countries: evidence from the European REVIVE Survey. Climacteric. 2016; 19:188-97.
• 48. Hunter MM, Nakagawa S, Van Den Eeden SK, Kuppermann M, Huang AJ. Predictors of impact of vaginal symptoms in postmenopausal women. Menopause. 2016; 23:40-6.
• 49. Masters WH, Johnson VE. Human Sexual Inadequacy. Boston, USA: Little, Brown; 1970.

Otras Fuentes 

• 50. Althof S. Psychogenic impotence: treatment of men and couples. In: Leiblum SR, ed. Principles and Practice of Sex Therapy. New York: Guilford Press; 1989:237-68.
• 51. Pâquet M, Rosen N, Steben M, Mayrand M, Santerre-Baillargeon M, Bergeron S. Daily anxiety and depressive symptoms in couples coping with vulvodynia: associations with women’s pain, women’s sexual function and both partners’ sexual distress. J Pain. 2018; 19:552-61.
• 52. Smith K, Pukall C, Boyer S. Psychological and relational aspects of dyspareunia. In: Goldstein A, Pukall, C, Goldstein, I, eds. Female Sexual Pain Disorders: Evaluation and Management. Oxford: Wiley-Blackwell; 2009.
• 53. Dogan S, Dogan M. The frequency of sexual dysfunctions in male partners of women with vaginismus in a Turkish sample. Int J Impot Res.2008; 20:218-21.
• 54. Althof S, Turner L, Levine S, Bodner D, Kursh E, Resnick M. Through the eyes of women: the sexual and psychological responses of women to their partners’ treatment with self-Injection or vacuum constriction therapy. J Urol. 1992; 147:1024-7.
• 55. Fisher W, Rosen R, Eardley I, Sand M, Goldstein I. Sexual experience of female partners of men with erectile dysfunction: The Female Experience of Men’s Attitudes to Life Events and Sexuality (FEMALES) Study. J Sex Med. 2005; 2:675-84.
• 56. Hobbs K, Symonds T, Abraham L, May K, Morris MF. Sexual dysfunction in partners of men with premature ejaculation. Int J Impot Res. 2008; 20:512-17.

Referencias Bibliográficas

• 57. Graziottin A. Prevalence and evaluation of sexual health problems—HSDD in Europe. J Sex Med. 2007;4(Suppl 3):211-19.
• 58. Rosen RC, Maserejian NN, Connor MK, Krychman ML, Brown CS, Goldstein I. Characteristics of premenopausal and postmenopausal women with acquired, generalized hypoactive sexual desire disorder: The Hypoactive Sexual Desire Disorder Registry for women. Menopause. 2012; 19:396-405.
• 59. Hartmann U, Heiser K, Ruffer-Hesse C, Kloth G. Female sexual desire disorders: subtypes, classification, personality factors and new directions for treatment. World J Urol. 2002; 20:79-88.
• 60. Clayton AH, Goldstein I, Kim NN, et al. The International Society for the Study of Women’s Sexual Health process of care for management of hypoactive sexual desire disorder in women. Mayo Clin Proc. 2018; 93:467-87.
• 61. Cuerva MJ, Gonzalez D, Canals M, et al. The sexual health approach in postmenopause: the five-minutes study. Maturitas. 2018; 108:31-6.
• 62. Clayton AH, Goldfischer ER, Goldstein I, Derogatis L, Lewis-D’Agostino DJ, Pyke R. Validation of the decreased sexual desire screener (DSDS): a brief diagnostic instrument for generalized acquired female hypoactive sexual desire disorder (HSDD). J Sex Med. 2009; 6:730-8.
• 63. Johannes CB, Clayton AH, Odom DM, et al. Distressing sexual problems in United States women revisited: prevalence after accounting for depression. J Clin Psychiatry. 2009; 70:1698-706.
• 64. Atlantis E, Sullivan T. Bidirectional association between depression and sexual dysfunc a systematic review and meta-analysis. J Sex Med. 2012; 9:1497-507.
• 65. Lamont J, Bajzak K, Bouchard C, et al. Female sexual health consensus clinical guidelines. J Obstet Gynaecol Can. 2012; 34:769-75.

Otras Referencias Bibliográficas

• 66. Randolph JF, Jr, Zheng H, Avis NE, Greendale GA, Harlow SD. Masturbation frequency and sexual function domains are associated with serum reproductive hormone levels across the menopausal transition. J Clin Endocrinol Metab. 2015; 100:258-66.
• 67. Goldstein I, Kim NN, Clayton AH, et al. Hypoactive sexual desire disorder: International Society for the Study of Women’s Sexual Health (ISSWSH) Expert Consensus Panel Review. Mayo Clin Proc. 2017; 92:114-28.
• 68. Wierman ME, Arlt W, Basson R, et al. Androgen therapy in women: a reappraisal: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2014; 99:3489-510.
• 69. Kingsberg SA, Althof S, Simon JA, et al. Female sexual dysfunction-medical and psychological treatments, Committee 14. J Sex Med. 2017; 14:1463-91.
• 70. Kingsberg SA, Rezaee RL. Hypoactive sexual desire in women. Menopause. 2013; 20:1284-300.
• 71. Goldstein I, Clayton AH, Goldstein AT, Kim NN, Kingsberg S. Textbook of Female Sexual Function and Dysfunction: Diagnosis and Treatment. Hoboken, NJ, USA: Wiley-Blackwell; 2018.
• 72. Brotto L, Atallah S, Johnson-Agbakwu C, et al. Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med. 2016; 13:538-71.
• 73. Brotto LA, Goldmeier D. Mindfulness interventions for treating sexual dysfunctions: the gentle science of finding focus in a multitask world. J Sex Med. 2015; 12:1687-9.
• 74. Brotto LA, Basson R, Luria M. A mindfulnessbased group psychoeducational intervention targeting sexual arousal disorder in women. J Sex Med. 2008; 5:1646-59.
• 75. Annon JS. The PLISSIT Model: a proposed conceptual scheme for the behavioral treatment of sexual problems. J Sex Educ Ther. 2015; 2:1-15.
• 76. Stuenkel CA, Davis SR, Gompel A, et al. Treatment of symptoms of the menopause: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2015; 100:3975-4011.

Fuentes Bibliográficas

• 77. Santen RJ, Stuenkel CA, Davis SR, Pinkerton JV, Gompel A, Lumsden MA. Managing menopausal symptoms and associated clinical issues in breast cancer survivors. J Clin Endocrinol Metab. 2017; 102:3647-61.
• 78. Bouchard C, Labrie F, Archer DF, et al. Decreased efficacy of twice-weekly intravaginal dehydroepiandrosterone on vulvovaginal atrophy. Climacteric. 2015; 18:590-607.
• 79. Bell RJ, Rizvi F, Islam MR, Davis SR. A systematic review of intravaginal testosterone for the treatment of vulvovaginal atrophy. Menopause 2017 Dec 28. doi: 10.1097/GME.0000000000001052. Epub ahead of print.
• 80. Cruz VL, Steiner ML, Pompei LM, et al. Randomized, double-blind, placebo-controlled clinical trial for evaluating the efficacy of fractional CO2 laser compared with topical estriol in the treatment of vaginal atrophy in postmenopausal women. Menopause. 2018; 25:21-8.
• 81. Gambacciani M, Levancini M, Cervigni M. Vaginal erbium laser: the second-generation thermotherapy for the genitourinary syndrome of menopause. Climacteric. 2015; 18:757-63.
• 82. Gartoulla P, Worsley R, Bell RJ, Davis SR. Moderate-severe vasomotor and sexual symptoms remain problematic for 60-65-year-old women. Menopause. 2015;22(7):694-701.
• 83. Zeleke BM, Bell RJ, Billah B, Davis SR. Vasomotor and sexual symptoms in older Australian women: a cross-sectional study. Fertil Steril 2016; 105:149-55. e141.
• 84. Kingsberg SA, Krychman M, Graham S, Bernick B, Mirkin S. The Women’s EMPOWER Survey: identifying women’s perceptions on vulvar and vaginal atrophy and its treatment. J Sex Med. 2017; 14:413-24.
• 85. Santoro N, Worsley R, Miller KK, Parish SJ, Davis SR. Role of estrogens and estrogen-like compounds in female sexual function and dysfunction. J Sex Med. 2016; 13:305-16.

Otras Fuentes Bibliográficas

• 86. Davis SR, Worsley R, Miller KK, Parish SJ, Santoro N. Androgens and female sexual function and dysfunction—findings from the Fourth International Consultation of Sexual Medicine. J Sex Med. 2016; 13:168-78.
• 87. Shifren J, Davis SR, Moreau M, et al. Testosterone patch for the treatment of hypoactive sexual desire disorder in naturally menopausal women: results from the INTIMATE NM1 study. Menopause. 2006;
  13:770-9.
• 88. Davis SR. Cardiovascular and cancer safety of testosterone in women. Curr Opin Endocrinol Diabetes Obes. 2011; 18:198-203.
• 89. Alkatib AA, Cosma M, Elamin MB, et al. A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA treatment effects on quality of life in women with adrenal insufficiency. J Clin Endocrinol Metab. 2009; 94:3676-81.
• 90. Elraiyah T, Sonbol MB, Wang Z, et al. Clinical review: The benefits and harms of systemic dehydroepiandrosterone (DHEA) in postmenopausal women with normal adrenal function: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2014; 99:3536-42.
• 91. Worsley R, Santoro N, Miller KK, Parish SJ, Davis SR. Hormones and female sexual dysfunction: beyond estrogens and androgens— findings from the Fourth International Consultation on Sexual Medicine. J Sex Med. 2016; 13:283-90.
• 92. Thorp J, Simon J, Dattani D, et al. Treatment of hypoactive sexual desire disorder in premenopausal
  women: efficacy of flibanserin in the DAISY study. J Sex Med. 2012; 9:793-804.
• 93. Derogatis LR, Komer L, Katz M, et al. Treatment of hypoactive sexual desire disorder in premenopausal women: efficacy of flibanserin in the VIOLET Study. J Sex Med. 2012; 9:1074-85.
• 94. Katz M, DeRogatis LR, Ackerman R, et al. Efficacy of flibanserin in women with hypoactive sexual desire disorder: results from the BEGONIA trial. J Sex Med. 2013; 10:1807-15.

Fuentes Referenciales

• 95. Simon JA, Kingsberg SA, Shumel B, Hanes V, Garcia M, Jr, Sand M. Efficacy and safety of flibanserin in postmenopausal women with hypoactive sexual desire disorder: results of the SNOWDROP trial. Menopause. 2014; 21:633-40.
• 96. Segraves RT, Clayton A, Croft H, Wolf A, Warnock J. Bupropion sustained release for the treatment of hypoactive sexual desire disorder in premenopausal women. J Clin Psychopharmacol. 2004; 24:339-42.
• 97. Fava M, Rush AJ, Thase ME, et al. 15 years of clinical experience with bupropion HCl: from bupropion to bupropion SR to bupropion XL. Prim Care Companion J Clin Psychiatry. 2005; 7:106-13.
• 98. Clayton AH, Warnock JK, Kornstein SG, Pinkerton R, Sheldon-Keller A, McGarvey EL. A placebo-controlled trial of bupropion SR as an antidote for selective serotonin reuptake inhibitor- induced sexual dysfunction. J Clin Psychiatry. 2004; 65:62-7.
• 99. Landen M, Eriksson E, Agren H, Fahlen T. Effect of buspirone on sexual dysfunction in depressed patients treated with selective serotonin reuptake inhibitors. J Clin Psychopharmacol. 1999; 19:268-71.
• 100. Stahl SM. Targeting circuits of sexual desire as a treatment strategy for hypoactive sexual desire disorder. J Clin Psychiatry. 2010; 71:821-2.
• 101. Clayton AH, Althof SE, Kingsberg S, et al. Bremelanotide for female sexual dysfunctions in premenopausal women: a randomized, placebo-controlled dose-finding trial. Womens Health (Lond). 2016; 12:325-37.

Bibliografías Referenciales

• 102. Tuiten A, van Rooij K, Bloemers J, et al. Efficacy and safety of on-demand use of 2 treatments designed for different etiologies of female sexual interest/arousal disorder: 3 randomized clinical trials. J Sex Med. 2018; 15:201-16.
• 103. Pyke R, Katz M, Segraves RT, Sitchon N. Phase IIa study of a proprietary combination of bupropion and trazodone for hypoactive sexual desire disorder (HSDD) in premenopausal women: novel responder and remitter results [poster]. Presented at Annual Meeting of American Society of Clinical Psychopharmacology; Miami FL, USA; 22-25 June, 2015.