- Describe your topic.
- Our topic nomination is Female Sexual Dysfunction (FSD). The following is a list of clinical questions practitioners consider when managing such cases: a. What is the initial approach to a patient who presents with a possible sexual dysfunction? Include targeted checklist of questions to ask to elicit the presence of any symptoms. Include who not to treat. b. Which medications are associated with female sexual dysfunction? c. What is the effect of hysterectomy on sexual function? What is the effect of supracervical hysterectomy on postoperative sexual function compared with hysterectomy with removal of the cervix? d. What is the role of estrogen therapy on sexual function? e. What is the evidence for the safety and efficacy of medications and devices to treat female arousal disorders? f. What is the evidence for the safety and efficacy of androgen therapy in the treatment of sexual interest/arousal disorders? g. What are the risks of androgen therapy, and how should patients be monitored? i. Hirsutism ii. Acne iii. Virilization iv. Cardiovascular risk v. Breast cancer h. What are the treatment options for genito-pelvic pain/penetration disorders? (Comment on behavioral/pyschotherapy, medications, etc.) i. How is postpartum FSD identified and treated? The population of interest includes women with female sexual dysfunction. The interventions we would like to know more about include androgen therapy, behavioral/psychotherapy, and other medications. The outcomes include improvement in sexual dysfunction .
- Describe why this topic is important.
- Female sexual dysfunction encompasses several conditions that are characterized by one of the following symptoms: loss of sexual desire, impaired arousal, inability to achieve orgasm, or sexual pain . Its symptoms result in personal distress and have an adverse effect on the quality of life of affected women. Obstacles to discussing and treating FSD include a lack of adequate training and confidence in the topic, few perceived treatment options, inadequate clinical time to obtain a sexual history, patients' reluctance to initiate the conversation, and the underestimation of the prevalence of sexual dysfunction.
- Tell us why you are suggesting this topic.
- This topic is being recommended because of the multifactorial nature of FSD. Loss of sexual desire, impaired arousal, inability to achieve orgasm, and sexual pain are often associated with medication use, other gynecologic or chronic comorbidities, past sexual trauma, or unknown factors. The prevalence of FSD symptoms ranges from 5-22%, representing a sizable portion of women who need physicians that can provide them with evidence-based options for diagnosis and treatment.
- Target Date.
- Describe what you are doing currently and what you are hoping will change because of a new evidence report.
- ACOG is currently working on a revision of the clinical guidance found in the Practice Bulletin on Female Sexual Dysfunction. We hope that a new evidence report will provide more definitive information on factors associated with FSD and how to identify and treat women who might have FSD.
- How will you or your group use the information from a new evidence report?
- A new evidence report on FSD will be used to develop future clinical guidance in the form of Practice Bulletins or Committee Opinions on this topic. Clinicians will then be better qualified to identify, make appropriate treatment decisions, and improve health outcomes for women with FSD.
- How would you or your group plan to disseminate information from the report? Who would you plan to disseminate it to?
- ACOG will share the information in this report with its 57,000 members through our website, and will update our clinical guidance to be reflective of the findings from this report.
- Do you know of organizations that could use an evidence report to change clinical practice? Are you a part of, or have you been in contact with, any organizations that might implement the research findings of an evidence report?
- American Society for Reproductive Medicine, American College of Physicians, American Urogynecologic Society
- Information About You: (optional)
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- Provide a description of your role or perspective.
- Professional society
- If you are you making a suggestion on behalf of an organization, please state the name of the organization.
- The American College of Obstetricians and Gynecologists
- Please tell us how you heard about the Effective Health Care Program.
- AHRQ Alert/Correspondence
