Materiały źródłowe

• #1 Predictors of female sexual dysfunction: a systematic review and qualitative analysis through gender inequality paradigms | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-018-0602-4

  Female sexual dysfunction affects 41% of reproductive-age women worldwide, making it a highly prevalent medical issue. A synthesis of potential risk factors and protective factors may aid healthcare practitioners in identifying populations at risk, in addition to revealing modifiable factors to prevent sexual dysfunction among reproductive-age women. […] Consistently significant protective factors included: older age at marriage, exercising, daily affection, intimate communication, having a positive body image, and sex education. […] Future prevention strategies should aim to address modifiable factors, e.g. physical activity and access to sex education; international efforts in empowering women should continue. […] Protective factors, regardless of population, regime, or level of development, were: sex education, exercise, older age at marriage, daily affection, intimate communication, having a positive body image, and finding sex to be important. Since several of these factors are modifiable, preventive measures could be taken to potentially avert the onset of female sexual dysfunction.

• #1 Female Sexual Dysfunction Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/2500107-treatment

  There is evidence that continued sexual activity is protective against later development of sexual dysfunction in menopausal women. […] Although this association may partly reflect a lower risk of FSD-related problems in those who are able to remain sexually active, it is physiologically plausible that sexual stimulation leads to increased blood flow and preserved elasticity that may protect against vulvovaginal atrophy and its sexual sequelae.

• #1 Sexual Dysfunction – The Center for Specialized Women’s Health – Denville, NJ

  https://specializedwomenshealth.com/services/sexual-dysfunction/

  While there isn’t a single way to prevent sexual dysfunction, you can reduce your risk by: Avoiding drugs and too much alcohol. Eating a balanced diet. Exercising regularly. Maintaining a healthy body weight. Seeking help from a health care professional if you are experiencing trouble with your mood or difficulty communicating with your partner. […] Also, talk to your healthcare provider about sexual dysfunction risk before starting new medications or undergoing certain medical procedures.

• #1 Female Sexual Dysfunction | Female Sexual Dysfunction Treatment

  https://norehealth.com/female-sexual-dysfunction-treatment/

  Treatment Options for Menopausal Sexual Dysfunction: Hormone therapy: Systemic or local estrogen therapy can help alleviate vaginal dryness and improve sexual function. Vaginal moisturizers and lubricants: These can provide relief from dryness and discomfort during intercourse. Pelvic floor exercises: Strengthening the pelvic floor muscles can improve sexual sensation and reduce urinary incontinence. Lifestyle modifications: Regular exercise, maintaining a healthy weight, and avoiding smoking can improve overall health and sexual function. Non-hormonal medications: Options like ospemifene or prasterone may be prescribed to improve vaginal health and sexual function. Counseling: Individual or couples therapy can address psychological factors affecting sexual function and intimacy. Stress Management: Techniques like mindfulness and meditation can reduce anxiety related to sexual activity. […] Recognizing the types and symptoms of FSD is the first step toward seeking appropriate treatment. We believe in a combination of medical interventions, therapy, and lifestyle changes can effectively manage symptoms, leading to enhanced sexual health and overall quality of life.

• #1 Urology Cure: Female Sexual Dysfunction Treatment Miami

  https://urologycure.com/female-sexual-dysfunction/

  Lower estrogen levels after menopause may lead to changes in your genital tissues and sexual responsiveness. A decrease in estrogen leads to decreased blood flow to the pelvic region, which can result in less genital sensation, as well as needing more time to build arousal and reach orgasm. […] Your bodys hormone levels also shift after giving birth and during breast-feeding, which can lead to vaginal dryness and can affect your desire to have sex. […] Untreated anxiety or depression can cause or contribute to sexual dysfunction, as can long-term stress and a history of sexual abuse. The worries of pregnancy and demands of being a new mother may have similar effects. […] Some factors may increase your risk of sexual dysfunction: Depression or anxiety, Heart and blood vessel disease, Neurological conditions, such as spinal cord injury or multiple sclerosis, Gynecological conditions, such as vulvovaginal atrophy, infections or lichen sclerosus, Certain medications, such as antidepressants or high blood pressure medications, Emotional or psychological stress, especially with regard to your relationship with your partner, A history of sexual abuse.

• #1 ACOG Guidance: Female Sexual Dysfunction – The ObG Project

  https://www.obgproject.com/2023/06/21/acog-guidance-female-sexual-dysfunction/

  SUMMARY: […] Female sexual dysfunction is relatively prevalent. Approximately 43% of American women report sexual problems. However, women are unlikely to report sexual dysfunction with providers unless asked. Dysfunction includes various conditions which report personal distress in one or more of the following areas: desire, arousal, orgasm, or pain. […] Clinical Considerations and Recommendations […] Screening […] Initiate a clinical discussion of sexual function during routine care visits […] If possible sexual dysfunction presents, an extended visit may be required including […] Comprehensive sexual history […] Physical examination to evaluate for gynecologic etiologies […] Laboratory testing typically not necessary […] Diagnosis […] Made according to the DSM-5 and classified as female sexual dysfunction when symptoms persist for at least 6 months

• #1 Female Sexual Dysfunction | Female Sexual Dysfunction Treatment

  https://norehealth.com/female-sexual-dysfunction-treatment/

  Treatment Options for Postpartum Sexual Dysfunction: Pelvic floor physical therapy: This can help strengthen weakened muscles and improve sexual function. Lubricants and moisturizers: These can alleviate vaginal dryness and discomfort during intercourse. Counseling: Individual or couples therapy can address psychological factors affecting sexual function. Hormone therapy: In some cases, localized estrogen therapy may be recommended to improve vaginal health. Pain management: For women experiencing pain during intercourse, various treatment options, including topical anesthetics or pelvic floor relaxation techniques, may be helpful. […] Treatment Options for Perimenopausal Sexual Dysfunction: Hormone therapy: Systemic or local estrogen therapy can help alleviate symptoms like vaginal dryness and low libido. Lubricants and moisturizers: These can provide relief from vaginal dryness and discomfort during intercourse. Lifestyle modifications: Regular exercise, stress management techniques, and a healthy diet can improve overall well-being and sexual function. Counseling: Therapy can help address psychological factors contributing to sexual dysfunction. Medications: In some cases, medications like ospemifene or prasterone may be prescribed to improve sexual function.

• #1 ACOG Female Sexual Dysfunction Guideline Summary

  https://www.guidelinecentral.com/guideline/41898/

  Low-dose vaginal estrogen therapy is the preferred hormonal treatment for female sexual dysfunction that is due to genitourinary syndrome of menopause.

• #1 Sexual dysfunction in women: Can we talk about it? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/84/5/367

  In treating sexual health problems in women, we address contributing factors identified during the initial assessment. […] As sexual dysfunction in women is often multifactorial, management of the problem is well suited to a multidisciplinary approach. The team of providers may include: A medical provider (primary care provider, gynecologist, or sexual health specialist) to coordinate care and manage biological factors contributing to sexual dysfunction, A physical therapist with expertise in treating pelvic floor disorders, A psychologist to address psychological, relational, and sociocultural contributors to sexual dysfunction, A sex therapist to facilitate treatment of tight, tender pelvic floor muscles through education and guidance about kinesthetic awareness, muscle relaxation, and dilator therapy.

• #1 Female Sexual Dysfunction | Female Sexual Dysfunction Treatment

  https://norehealth.com/female-sexual-dysfunction-treatment/

  Female sexual dysfunction is a complex and multifaceted issue that can significantly impact a woman’s quality of life and relationships. […] By understanding the various types of female sexual dysfunction and the treatment options available, women can take proactive steps to address their sexual health concerns. […] Regardless of life stage, a comprehensive approach to treating female sexual dysfunction often yields the best results. This may include: Thorough medical evaluation: Identifying and addressing any underlying medical conditions that may be contributing to sexual dysfunction. Psychological assessment: Exploring mental health concerns, relationship issues, or past traumas that may be impacting sexual function. Lifestyle modifications: Encouraging healthy habits such as regular exercise, stress management, and a balanced diet. Pelvic floor therapy: Working with a specialized physical therapist to improve pelvic floor muscle function and reduce pain. Medications: Prescribing appropriate medications to address specific symptoms or underlying conditions. Sex therapy: Providing education, counseling, and specific techniques to improve sexual function and satisfaction. Alternative therapies: Exploring options such as acupuncture, mindfulness practices, or yoga to complement traditional treatments.

• #1 ACOG Guidance: Female Sexual Dysfunction – The ObG Project

  https://www.obgproject.com/2023/06/21/acog-guidance-female-sexual-dysfunction/

  Exception: substance and/or medication-induced sexual dysfunction […] Symptoms must result in significant personal distress […] Women often experience more than one type of female sexual dysfunction simultaneously […] A woman may still benefit from evaluation and treatment even if their symptoms do not meet DSM-5 criteria […] Treatment […] Psychologic Interventions […] Sexual skills training | Cognitive-behavioral therapy | Mindfulness-based therapy | Couples therapy […] Patient should consult a mental health professional having expertise in treating female sexual dysfunction […] Estrogen Therapy […] Low-dose vaginal estrogen therapy is preferred for female sexual dysfunction due to genitourinary syndrome of menopause (GSM) […] Vaginal tablets | Gels | Creams | Rings

• #1 JMIR Research Protocols – Psychological Treatment of Low Sexual Desire in Women: Protocol for a Randomized, Waitlist-Controlled Trial of Internet-Based Cognitive Behavioral and Mindfulness-Based Treatments

  https://www.researchprotocols.org/2020/9/e20326/

  Psychological therapies are effective treatments for hypoactive sexual desire dysfunction (HSDD; formerly hypoactive sexual desire disorder), a common sexual dysfunction among women. […] Internet-based interventions are effective for a variety of psychological disorders and may be a promising means to close the treatment gap for HSDD. […] A meta-analysis found psychological interventions to be effective treatments for low sexual desire and effects for symptom reduction were large compared to waitlist controls (d=0.91; 95% CI 0.38-1.45; P=.012). […] Psychological interventions for low desire often comprise a variety of components such as psychological and sexual education, couples exercises, guided masturbation, communication training, cognitive behavioral as well as mindfulness-based techniques.

• #1 FEMALE SEXUAL DYSFUNCTION: THE IMPORTANT POINTS TO REMEMBER | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-female-sexual-dysfunction-the-important-S1807593222032161

  FEMALE SEXUAL DYSFUNCTION: THE IMPORTANT POINTS TO REMEMBER […] Therefore, it is of extreme importance that these professionals become knowledgeable about and comfortable with the initial evaluation and possible treatment of female sexual dysfunction. […] Physicians who have a good rapport with these patients are in a unique position to help with these intimate problems, which are often difficult for patients to discuss. […] Therefore, it is of utmost importance to general practitioners, gynecologists, geriatrists, and urologists to become knowledgeable about and comfortable with the initial evaluation and possible treatment of FSD. […] Despite the prevalence of FSD, many women may be too embarrassed or reluctant to initiate a discussion of their sexual problems. […] Since general practitioners, gynecologists, geriatrists, and urologists will be seeing an increasing number of women with either overt or covert sexual dysfunction, it has become prudent to learn how best to treat or refer appropriately.

• #1 Sexual dysfunction in women: Can we talk about it? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/84/5/367

  The intimacy-based female sexual response model suggests that while a woman may experience spontaneous sexual desire, a desire for emotional closeness or intimacy may also predispose her to engage in sexual activity. Biological, psychological, and sociocultural factors may adversely affect female sexual response. […] The assessment of sexual health concerns should be a part of a routine health examination, particularly after childbirth and other major medical, surgical, psychological, and life events. […] To overcome these barriers: Legitimize sexual health as an important health concern and normalize its discussion as part of a routine clinical health assessment. […] Factors that can contribute to female sexual dysfunction include biological factors, psychological factors, sociocultural factors, and relationship factors. […] Treatment of the genital and urinary symptoms related to loss of estrogen after menopause (genitourinary syndrome of menopause) includes the use of vaginal lubricants with sexual activity and vaginal moisturizers on a regular basis.

• #1

  https://scholars.duke.edu/individual/pub1487466

  OBJECTIVE: Provide an overview of sexual dysfunction in female urologic cancer patients, approaches for assessing sexual problems, and interventions to treat sexual dysfunction in this patient population. […] Urologic cancer treatments commonly result in sexual dysfunction (e.g., dyspareunia, vaginal dryness, problems with orgasm) in female patients, although more research is necessary to understand the impact of non-surgical treatments (e.g., radiation, chemotherapy, immunotherapy). […] As such, provider teams should complete necessary screening for sexual dysfunction during and after treatment. […] The 5 A’s model (i.e., Ask, Advise, Assess, Assist, Arrange Follow-Up) provides a helpful guide for communicating about and addressing sexual health concerns with patients during the screening process.

• #1 Sexual Dysfunction: Disorders, Causes, Types & Treatment

  https://my.clevelandclinic.org/health/diseases/9121-sexual-dysfunction

  No, you cant prevent it. But you can take steps to reduce its impact on your life. The first step is to be aware of it and recognize when its time to seek help. It may feel frustrating and upsetting to accept help. But, in most cases, you did nothing to cause sexual dysfunction. Fortunately, most causes of sexual dysfunction are treatable.

• #2 Female Sexual Dysfunction in Chicago – Diagnosis & Treatment

  https://www.northwesternobgyn.com/gynecology/sexual-dysfunction-northwestern-chicago.html

  Female sexual dysfunction is actually quite a common problem in our country. According to the National Institutes of Health: Female sexual dysfunction affects approximately 40 percent of the female American population. Factors involved in female sexual dysfunction include hormones and physical and psychological wellbeing. Medical conditions like cardiovascular disease and diabetes play a role in female sexual dysfunction. Very little research has been done on female sexual dysfunction. The majority of research on this topic has centered on the psychological factors of female dysfunction. […] The good news is that there is help for the various causes of sexual dysfunction. The first step is to determine if this condition exists. Most women are well enough acquainted with themselves to recognize the signs of sexual dysfunction. These include the inability to reach climax, lack of arousal and lack of libido, vaginal dryness, and pain during intercourse.

• #2 Female Sexual Dysfunction: Signs, Causes & Treatment Options

  https://my.vanderbilthealth.com/female-sexual-dysfunction/

  Female sexual dysfunction is common, but problems can be treated. […] Many women share an approach to their sexual problems: They dont talk about them, let alone seek help. […] If youre experiencing pain during sex, or a lack of desire to have sex, or other problems, its important to talk about it with your doctor, midwife or nurse practitioner. […] Treatment for female sexual dysfunction is available and worth trying. […] Possible treatment options for female sexual dysfunction can include counseling or cognitive behavioral therapy; lifestyle changes such as weight loss or smoking cessation; prescription estrogen treatment; vaginal moisturizers and lubricants; short-term testosterone therapy; and a prescription device called Eros that increases blood flow to the genitals. […] Sexual health is an important part of overall well-being, so dont brush it off.

• #2 Female Sexual Dysfunction: Symptoms, Types, Causes & Treatments

  https://resources.healthgrades.com/right-care/sexual-health/female-sexual-dysfunction

  You may be able to lower your risk of female sexual dysfunction by developing a healthy attitude toward yourself and sex. This may include learning to accept and even appreciate your body and being comfortable with yourself as a sexual being. […] Try these lifestyle habits to enhance your sexual health: […] Treat medical conditions that can contribute to FSD. […] Having an established relationship with a doctor you trust can help you address any potential problems in a timely manner. See your doctor sooner rather than later if issues with sex begin to trouble you. If necessary, your doctor can refer you to a sexual health specialist. […] Doctors recommend treatment of female sexual dysfunction if the problem bothers you or interferes with your relationships. Because the symptoms and causes of FSD are often interrelated, treatment usually relies on more than one approach including: […] Your healthcare provider will tailor the treatment based on your individual needs. Be upfront and honest about the symptoms that bother you and your goals.

• #2 Managing female sexual dysfunction – Women’s Healthcare

  https://www.npwomenshealthcare.com/managing-female-sexual-dysfunction/

  Although about one-third of women report concerns with sexual functioning, many healthcare providers (HCPs) do not feel comfortable screening for, diagnosing, or managing female sexual dysfunction (FSD). […] To this end, the authors provide evidence-based recommendations drawn from the current literature regarding assessment and diagnosis of FSD, with an emphasis on pharmacologic options available to treat FSD. […] Healthcare providers can increase the likelihood that FSD will be identified and addressed by initiating the conversation with patients, which will strengthen the HCPpatient relationship and help normalize patients concerns. […] For women in whom FSD is diagnosed, nonpharmacologic interventions include CBT, sex therapy, self-stimulation, and lubricants. […] Two medications—conjugated estrogens vaginal cream and ospemifene—have a specific indication for dyspareunia. […] Although no pharmacologic agent has been approved by the FDA to treat desire, arousal, or orgasmic dysfunction in women, interest in such agents is growing.

• #2 Sexual dysfunction in women: Can we talk about it? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/84/5/367

  The intimacy-based female sexual response model suggests that while a woman may experience spontaneous sexual desire, a desire for emotional closeness or intimacy may also predispose her to engage in sexual activity. Biological, psychological, and sociocultural factors may adversely affect female sexual response. […] The assessment of sexual health concerns should be a part of a routine health examination, particularly after childbirth and other major medical, surgical, psychological, and life events. […] To overcome these barriers: Legitimize sexual health as an important health concern and normalize its discussion as part of a routine clinical health assessment. […] Factors that can contribute to female sexual dysfunction include biological factors, psychological factors, sociocultural factors, and relationship factors. […] Treatment of the genital and urinary symptoms related to loss of estrogen after menopause (genitourinary syndrome of menopause) includes the use of vaginal lubricants with sexual activity and vaginal moisturizers on a regular basis.

• #2 Female Sexual Dysfunction | Female Sexual Dysfunction Treatment

  https://norehealth.com/female-sexual-dysfunction-treatment/

  Treatment Options for Menopausal Sexual Dysfunction: Hormone therapy: Systemic or local estrogen therapy can help alleviate vaginal dryness and improve sexual function. Vaginal moisturizers and lubricants: These can provide relief from dryness and discomfort during intercourse. Pelvic floor exercises: Strengthening the pelvic floor muscles can improve sexual sensation and reduce urinary incontinence. Lifestyle modifications: Regular exercise, maintaining a healthy weight, and avoiding smoking can improve overall health and sexual function. Non-hormonal medications: Options like ospemifene or prasterone may be prescribed to improve vaginal health and sexual function. Counseling: Individual or couples therapy can address psychological factors affecting sexual function and intimacy. Stress Management: Techniques like mindfulness and meditation can reduce anxiety related to sexual activity. […] Recognizing the types and symptoms of FSD is the first step toward seeking appropriate treatment. We believe in a combination of medical interventions, therapy, and lifestyle changes can effectively manage symptoms, leading to enhanced sexual health and overall quality of life.

• #2 ACOG Guidance: Female Sexual Dysfunction – The ObG Project

  https://www.obgproject.com/2023/06/21/acog-guidance-female-sexual-dysfunction/

  Exception: substance and/or medication-induced sexual dysfunction […] Symptoms must result in significant personal distress […] Women often experience more than one type of female sexual dysfunction simultaneously […] A woman may still benefit from evaluation and treatment even if their symptoms do not meet DSM-5 criteria […] Treatment […] Psychologic Interventions […] Sexual skills training | Cognitive-behavioral therapy | Mindfulness-based therapy | Couples therapy […] Patient should consult a mental health professional having expertise in treating female sexual dysfunction […] Estrogen Therapy […] Low-dose vaginal estrogen therapy is preferred for female sexual dysfunction due to genitourinary syndrome of menopause (GSM) […] Vaginal tablets | Gels | Creams | Rings

• #2 Sexual Dysfunction in Women: A Practical Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0815/p281.html

  Group cognitive behavior therapy may be effective for low sexual desire. […] Mindfulness-based interventions have been shown to effectively treat several types of female sexual dysfunction, including low sexual desire and arousal, and acquired anorgasmia. […] Directed masturbation training is the treatment of choice for lifelong anorgasmia. […] Sexual health concerns are common in natural or surgically induced menopause, particularly sexual pain related to genitourinary syndrome of menopause. […] Estrogen treatment is highly effective for genitourinary syndrome of menopause and related dyspareunia; local vaginal estrogen is preferred if vaginal dryness is the primary concern. […] Women with genitourinary syndrome of menopause and sexual pain may have dysfunctional pelvic floor muscles, which may become tense or tight as a result of ongoing vaginal dryness and discomfort or pain with sexual activity. […] If a patient reports distress but does not meet criteria for sexual dysfunction, intervention is still needed.

• #2 Female Sexual Health After Cancer | Livestrong

  https://livestrong.org/resources/female-sexual-health-after-cancer/

  One area of life that cancer and treatment might change is the ability to have or enjoy sex. This is sometimes referred to as female sexual dysfunction and can affect you physically and emotionally. We can help. […] If you develop a sexual problem, talk to your health care provider as early as possible about any symptoms or concerns. […] Sexuality is an important part of your quality of life after cancer. […] New sexual problems often begin during or soon after cancer treatment. Be certain to discuss any problems and symptoms with your health care providerespecially if you begin to notice any changes in your ability to have or enjoy sex. […] Talk with your health care team about the risks to sexual functioning before you begin cancer treatment. If you have already undergone treatment, talk with your health care provider about finding ways to treat symptoms or concerns now.

• #3 Hope for Women with Sexual Dysfunction

  https://consultqd.clevelandclinic.org/hope-for-women-with-sexual-dysfunction

  Female sexual dysfunction is a prevalent but often-undertreated phenomenon, especially among cancer survivors. The problems, which include low sexual desire, difficulty reaching orgasm or pain on intercourse, among others, can be devastating to women and their partners. […] Luckily, multiple treatments are available to help such women. Treatments include detailed sexual education, mindfulness therapies, counseling, pelvic floor physical therapy, systemic and vaginal hormonal treatments (both estrogen and nonestrogen), as well as nonhormonal medications. […] The Female Sexual Dysfunction Program also cares for women who have concerns about issues related to hormonal changes, such as genitourinary syndrome of menopause, which leaves more than half of all postmenopausal women with symptoms such as vulvovaginal dryness or atrophy, burning, irritation, dyspareunia, urinary urgency, dysuria and urinary tract infections.

• #3 JMIR Research Protocols – Psychological Treatment of Low Sexual Desire in Women: Protocol for a Randomized, Waitlist-Controlled Trial of Internet-Based Cognitive Behavioral and Mindfulness-Based Treatments

  https://www.researchprotocols.org/2020/9/e20326/

  Psychological therapies are effective treatments for hypoactive sexual desire dysfunction (HSDD; formerly hypoactive sexual desire disorder), a common sexual dysfunction among women. […] Internet-based interventions are effective for a variety of psychological disorders and may be a promising means to close the treatment gap for HSDD. […] A meta-analysis found psychological interventions to be effective treatments for low sexual desire and effects for symptom reduction were large compared to waitlist controls (d=0.91; 95% CI 0.38-1.45; P=.012). […] Psychological interventions for low desire often comprise a variety of components such as psychological and sexual education, couples exercises, guided masturbation, communication training, cognitive behavioral as well as mindfulness-based techniques.

• #3 Sexual Dysfunction – The Center for Specialized Women’s Health – Denville, NJ

  https://specializedwomenshealth.com/services/sexual-dysfunction/

  While there isn’t a single way to prevent sexual dysfunction, you can reduce your risk by: Avoiding drugs and too much alcohol. Eating a balanced diet. Exercising regularly. Maintaining a healthy body weight. Seeking help from a health care professional if you are experiencing trouble with your mood or difficulty communicating with your partner. […] Also, talk to your healthcare provider about sexual dysfunction risk before starting new medications or undergoing certain medical procedures.

• #3 Female sexual dysfunction: Why is it so difficult to treat? –

  https://www.npwomenshealthcare.com/female-sexual-dysfunction-vol3-no4/

  Considering the high prevalence of FSD, and the likelihood that it is distressing to at least a sizable minority of women who have it, HCPs must aim to identify it and treat it despite the barriers that still exist. […] Addressing patients concerns in a holistic manner, establishing rapport, and providing a nonjudgmental environment for discussion about sensitive topics is the best method to facilitate success in this patient population.

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