Female Sexual Interest Arousal Disorder By Dr Bahare

Female Sexual Interest/ Arousal Disorder By: Dr. Bahare Sabbagh Abrishami( M. D) Psychiatrist Sex Therapist Couple Therapist

Sexual response

Female Sexual Dysfunction In DSM IV

Female Sexual Interest/ Arousal Disorder In DSM V

Basson Model Of Sexual Response

Intersystemic Model Approach � 1 - Indiviual: Each partner ‘s biological and psychosocial dynamics � 2 -Interactional: The couple ‘s relationship � 3 -Intergeneration: Factors learned within the families of origin & expressed in the present.

Medical causes � Hyper & Hypothyroid � Genitourinary diseases � Arthritis � IBS-IBD � DM � HTN � Spinal cord injury, MS, Peripheral neuropathy, Neuromascular Dis. � Parkinson, Dementia � Renal failure � Liver Cirrhosis � Pituitary adenoma � Chronic Cardiopulmonary Disease

Psychosocial Factor � Sexual abuse & traumatic experiences � Sexual abstinence � Acute &chronic stress � Distraction � Self focus attention � Psychiatric Dis. Such as anxiety, Depression, OCD… � Partner sexual problem � Relation problem � Lack of sufficient stimulation/Lack of intimacy � Lack of privacy � Cultural aspects & Religious affiliation � Lifetime events as divorce, small children in home, Widower’s syndrome � Fear of pregnancy

Iatrogenic Factors

Evaluation � 1. � 2. � 3. � 4. How often do you have sex? How often do you feel like having sex? Do you believe your desire level is too low? When did you first notice losing desire for sex? What was happening at � that time? � 5. Did you lose desire rapidly or slowly? � 6. What was your level of sexual desire earlier in your relationship? � 7. Any changes in your health? What medications are you taking now? � 8. On a scale of 1 to 10 how much desire do you feel in general? Prior to � sex? During sex? � 9. How often do you think about sex or fantasize about romantic scenarios?

Assessment

Questionnaires �Female Sexual Function Index (FSFI) �Sexual Interest and Desire Inventory- Female (SIDI-F)

Lab. Tests �Total testosterone- Free testosterone- SHBG- Albumin �Estradiol & FSH �Prolactine �TFT

Hormonal therapy

Non hormonal Tx. Fibanserin ( Addyi - Pink viagra )

Sex Therapy

CBT

Maintenance �The therapist must be mindful that relapse is to be expected �Sexual desire is maintained through active sensual and sexual contact with one another. �sensual touching and caressing