Shaikh Zinnat Ara Nasreen
ZH Shikder Women’s Medical College & Hospital, Bangladesh
FSD is a, multidimensional, complex and challenging topic, which was not discussed before 1950. In last 20 years, explosion of research shaded much light on understanding of FSD. Starting from Kinsey (1960), Master & Jhoson (1966), Kalpan (1970-1979), Basson (2004) and many other researchers worked hard. Kalpan modified Master’s female sexual cycle in 3 phase model including desire, arousal, orgasm but recently reclassified (DMS-5) by AUAF.FSD are sexual interest disorder, arousal disorder, orgasmic disorder and painful sex.
Etiopathogenesis: FSD has tremendous effect in quality of women’s life, highly prevalent 20 %-40% (Lauman 99) in young and 48% in older women (Dinnestein 2003). Sexual behavior is controlled by a hormonally response neural network. Endocrine, neurological, psychiatric conditions, cancer medication and surgical procedures, local diseases, deficient estrogen- testosterone, biopsychosocial factors, relationship factor all are important beyond menopause. Nothing happens without desire again painful sex affects desire and all other domains of sexual cycle.
Diagnosis: Detailed history, General and pelvic examination and some Investigations need to be done. Therapy should be tailored according to the patient’s need along with multidisciplinary team including psychosexual counselor / sexologist / therapist / and physician. Successful resolution of low interest and pain disorder ameliorate FSD. Evidences support the use of testosterone, tropical estrogen, DHEA. MHT does not have direct effect on FSD but ospemephene and laser therapy are promising ns for vaginal atrophy.
Conclusion: Who deals FSD should possess not only the necessary wide medical knowledge, but also need empathy & compassion.
Shaikh Zinnat Ara Nasreen is a Professor and Head of Obs/Gyne department at ZH Shikder Women’s Medical College and Hospital, Dhaka. She is the Secretary General Bangladesh menopause society, Joint secretary Ob/Gyn society Bangladesh, Member Secretary,CPD, Committee, BCPS, CAMS Representative IMS, Treasurer RCOG Representative Bangladesh, Council member SASSM, Council member SAFOG, Council member SAFOMS, Member of IMS and Member of ISSM.