CDMX Clinical Vignette: J.L, a 45-year-old African American female, P3G3 status post-hysterectomy in 2014, presents to her OBGYN concerned about decreased sexual arousal. J.L.’s past medical history is significant for hysterectomy and bilateral oophorectomy a year and a half prior. She states that she noticed a significant decline in sexual desire after the hysterectomy and that it has caused increased interpersonal stress and feelings of inadequacy. Before her surgery, she states that her sex life with her husband was exceptional and healthy but now she feels to blame for a decrease in intimacy. She states that she still finds her husband attractive but wants to feel sexually stimulated and experience a resumption of satisfaction when they are intimate. She has been married to her husband for 10 years and they have 3 children together. She states that her relationship is monogamous and they have a…show more content… After the physical exam, the patient states that she recently learned of testosterone therapy for women with low sex drive and wonders if she could receive such treatment?
PICO: In postmenopausal women experiencing hypoactive sexual desire disorder, do transdermal testosterone patches increase sexual satisfaction and sexual desire when compared to a placebo?
Sexual desire disorder and/or sexual interest/arousal disorder, as characterized in DSM-5, is a complete cessation or significant reduction in sexual arousal or interest that is present 75-100% of the time for a period greater than 6 months and must be a causative factor in significant personal stress. Although ovaries are known for their estrogen secreting function, they are also responsible for producing physiologically significant levels of testosterone. In combination with the adrenals, they supply sufficient enough testosterone to serve an integral role in modulating the environment of the vaginal tissue so that it is receptive to physical sexual stimulation/intercourse and
