ORCID Profile
0000-0002-8771-3956
Current Organisation
The University of Texas at Austin
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Publisher: Oxford University Press (OUP)
Date: 03-2019
DOI: 10.1016/J.JSXM.2019.01.010
Abstract: In 2016 the International Society for the Study of Women’s Sexual Health (ISSWSH) published an expert consensus report on new nomenclature that addressed the need for comprehensive, evidence-based criteria for new diagnoses in desire, arousal, and orgasm, with the definition on arousal focusing exclusively on female genital arousal disorder (FGAD). A new expert panel solely focused on mechanisms of arousal disorders convened to revise the nomenclature to include female cognitive arousal disorder (FCAD) and FGAD. The ISSWSH co-chairs identified experts on arousal disorders in women. The 10 participants included clinicians, researchers, and educators, representing a erse, multidisciplinary group. Pre-meeting preparation included evidence-based literature review as the basis of presentations panelists made at the meeting on the current knowledge in cognitive arousal. Consensus was reached using a modified Delphi method. Writing assignments were made as a basis of manuscript development. The new definition of FCAD is characterized by distressing difficulty or inability to attain or maintain adequate mental excitement associated with sexual activity, as manifested by problems with feeling engaged and mentally turned on or sexually aroused for a minimum of 6 months. Female sexual arousal disorder encompasses both FGAD (revised definition) and FCAD (new definition). Recommendations regarding diagnosis include a clinical interview to assess for FCAD using targeted questions. Patient-reported outcomes that contain questions to assess FCAD are described, including limitations for differentiating between cognitive arousal, genital arousal, and sexual desire. Laboratory measures of cognitive and genital arousal are discussed, including the relationships between genital and cognitive arousal patterns. Biopsychosocial risk factors for FCAD and FGAD, as well as exclusionary conditions, are presented. The revision of the ISSWSH nomenclature regarding the criteria for the 2 arousal categories, FCAD and FGAD, and the recommended diagnostic strategies offers a framework for management of women with arousal disorders. This nomenclature allows for basic science and clinical research in subtypes of arousal in order to develop better diagnostic and treatment options for use by clinicians, scientists, and regulatory agencies. There are limited validated measures of cognitive arousal, including the Female Sexual Function Index, the most commonly used measure, which does not effectively distinguish between cognitive excitement, genital sensations, and event-related desire. Future directions include the refinement of FCAD and FGAD and development and validation of patient-reported outcomes that distinguish between the cognitive processes and genital responses to enhance clinical care and research in this area.
Publisher: Oxford University Press (OUP)
Date: 07-2004
DOI: 10.1111/J.1743-6109.2004.10105.X
Abstract: Women's sexual dysfunctions include persistent or recurrent disorders of sexual interest/desire, disorders of subjective and genital arousal, orgasm disorder, pain and difficulty with attempted or completed intercourse. There are limited recommendation/guideline documents pertaining to the diagnosis and treatment of women's sexual dysfunctions. To provide recommendations/guidelines concerning state-of-the-art knowledge for the clinical management of women's sexual dysfunctions. An International Consultation in collaboration with the major sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Ten experts from four countries compiled the Recommendations on Sexual Dysfunctions in Women. Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate. Recommendations and guidelines concerning the various sexual dysfunctions were updated. A comprehensive assessment of medical, sexual and psychosocial history is recommended for diagnosis and management planning. Indications for general and focused pelvic genital examination and laboratory testing are included. Recently revised definitions for sexual desire/interest disorder, arousal disorders (genital, subjective, combined and persistent), orgasm disorder, dyspareunia and vaginismus are presented. An evidence-based approach to management is provided. There is a need for more research and scientific reporting, re-assessment, and management of women's sexual dysfunction including long-term outcome studies.
No related grants have been discovered for Cindy Meston.