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Sexual Dysfunctions and Gender Dysphoria in Women

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Women's Mental Health

Abstract

The chapter deals with female sexual dysfunctions and gender dysphoria/incongruence in women. Concept, classification, clinical presentation, diagnosis and differential diagnosis, and treatment are the aspects addressed for each of these two categories. Preceding this content, the chapter considers the female sexual response cycle and its relation to the classification of female sexual dysfunction. This model also emphasizes the importance of emotional satisfaction during sexual activity and recognizes that female sexual functioning is more complex and is less linear than male sexual functioning. Another aspect that has received special mention in this chapter was the Brazilian program of assistance to transgender people, currently being updated by the experts. Nevertheless, the fundamental challenge remains as to how the standards of care will be negotiated, approved, and implemented by the public and private health authorities of various countries, in the context of broader sociopolitical issues. The whole text of the chapter is supplemented by diagnostic and therapeutic schemes that summarize these topics, to facilitate apprehension.

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References

  1. Vilarinho S, Laja P, Carvalho J, Quinta-Gomes AL, Oliveira C, Janssen E, et al. Affective and cognitive determinants of women’s sexual response to erotica. J Sex Med. 2014;11(11):2671–8.

    Article  PubMed  Google Scholar 

  2. Brotto L, Atallah S, Johnson-Agbakwu C, Rosenbaum T, Abdo C, Byers ES, et al. Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med. 2016;13(4):538–71.

    Article  PubMed  Google Scholar 

  3. American Psychiatric Association. DSM-5 diagnostic classification diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Press; 2013.

    Book  Google Scholar 

  4. Masters W, Johnson V. Human sexual response. Boston: Little, Brown and Company; 1966.

    Google Scholar 

  5. Kaplan H. Disorders of sexual desire and other new concepts and techniques in sex therapy. New York: Brunner/Hazel Publications; 1979.

    Google Scholar 

  6. Wright JJ, O’Connor KM. Female sexual dysfunction. Med Clin North Am. 2015;99(3):607–28.

    Article  PubMed  Google Scholar 

  7. Basson R. The female sexual response: a different model. J Sex Marital Ther. 2000;26(1):51–65.

    Article  CAS  PubMed  Google Scholar 

  8. Hayes R, Dennerstein L, Bennett C, Fairley C. What is the true prevalence of female sexual dysfunctions and does the way we assess these conditions have an impact? J Sex Med. 2008;5(4):777–87.

    Article  PubMed  Google Scholar 

  9. Berman J, Berman L, Goldstein I. Female sexual dysfunction: incidence, pathophysiology, evaluation, and treatment options. Urology. 1999;54(3):385–91.

    Article  CAS  PubMed  Google Scholar 

  10. World Health Organization. International Classification of Diseases (ICD); 2014. Retrieved 18.08.2018, from http://www.who.int/classifications/icd/en/.

  11. Khajehei M, Doherty M, Tilley M. An update on sexual function and dysfunction in women. Arch Womens Ment Health. 2015;18(3):423–33.

    Article  PubMed  Google Scholar 

  12. Basson R, Schultz WW. Sexual sequelae of general medical disorders. Lancet. 2007;369(9559):409–24.

    Article  PubMed  Google Scholar 

  13. Graziottin A, Serafini A, Palacios S. Aetiology, diagnostic algorithms and prognosis of female sexual dysfunction. Maturitas. 2009;63(2):128–34.

    Article  PubMed  Google Scholar 

  14. Labbate LA. Psychotropics and sexual dysfunction: the evidence and treatments. Adv Psychosom Med. 2008;29:107–30.

    Article  PubMed  Google Scholar 

  15. Basson R, Leiblum S, Brotto L, Derogatis L, Fourcroy J, Fugl-Meyer K, et al. Definitions of women’s sexual dysfunction reconsidered: advocating expansion and revision. J Psychosom Obstet Gynecol. 2003;24(4):221–9.

    Article  CAS  Google Scholar 

  16. Basson R. Women’s sexual dysfunction: revised and expanded definitions. Can Med Assoc J. 2005;172(10):1327–33.

    Article  Google Scholar 

  17. Nappi RE, Cucinella L, Martella S, Rossi M, Tiranini L, Martini E. Female sexual dysfunction (FSD): prevalence and impact on quality of life (QoL). Maturitas. 2016;94:87–91.

    Article  PubMed  Google Scholar 

  18. Althof S, McCabe M, Assalian P, Leiblum S, Chevert-Measson M, Simonelli C, et al. Psychological and interpersonal dimensions of sexual function and dysfunction. In: Montorsi F, Guiliano F, Lue T, Rosen RC, Khoury S, editors. Sexual medicine: sexual dysfunction in men and women. 3rd ed. Paris: Health Publications; 2010. p. 119–81.

    Google Scholar 

  19. Clayton AH, Valladares Juarez EM. Female sexual dysfunction. Psychiatr Clin North Am. 2017;40(2):267–84.

    Article  PubMed  Google Scholar 

  20. Fugl-Meyer KS. Sexual disabilities and sexual problems. In: Sex in Sweden. Stockholm: Swedish National Institute of Health; 2000. p. 199–216.

    Google Scholar 

  21. Burri A, Spector T. Recent and lifelong sexual dysfunction in female UK population sample: prevalence and risk factors. J Sex Med. 2011;8(9):2420–30.

    Article  PubMed  Google Scholar 

  22. Smith AMA, Lyons A, Ferris JA, Richters J, Pitts MK, Shelley JM, et al. Incidence and persistence/recurrence of women’s sexual difficulties: findings from the Australian Longitudinal Study of Health and Relationships. J Sex Marital Ther. 2012;38(4):378–93.

    Article  PubMed  Google Scholar 

  23. Leiblum SR, Hayes RD, Wanser RA, Nelson JS. Vaginal dryness: a comparison of prevalence and interventions in 11 countries. J Sex Med. 2009;6(9):2425–33.

    Article  PubMed  Google Scholar 

  24. Basson R, Gilks T. Women’s sexual dysfunction associated with psychiatric disorders and their treatment. Womens Health (Lond). 2018;14:1745506518762664.

    Google Scholar 

  25. de Pierrepont C, Polomeno V, Bouchard L, Reissing E. What do we know about perinatal sexuality? A scoping review on sexoperinatality - part 1. J Gynecol Obstet Biol Reprod (Paris). 2016;45(8):796–808.

    Article  Google Scholar 

  26. de Pierrepont C, Polomeno V, Bouchard L, Reissing E. What do we know about perinatal sexuality? A scoping review on sexoperinatality - part 2. J Gynecol Obstet Biol Reprod (Paris). 2016;45(8):809–20.

    Article  Google Scholar 

  27. Abdo CHN. Descobrimento sexual do Brasil. Summus: São Paulo; 2004.

    Google Scholar 

  28. Abdo CH, Valadares AL, Oliveira WM Jr, Scanavino MT, Afif-Abdo J. Hypoactive sexual desire disorder in a population-based study of Brazilian women: associated factors classified according to their importance. Menopause. 2010;17(6):1114–21.

    Article  PubMed  Google Scholar 

  29. Laumann EO, Nicolosi A, Glasser DB, Paik A, Ginge C, Moreira E, et al. Sexual problems among women and men aged 40-80 years: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res. 2005;17:39–57.

    Article  CAS  PubMed  Google Scholar 

  30. Lewis RW, Fugl-Meyer KS, Bosch R, Fugl-Meyer AR, Laumann EO, Lizza E, et al. Epidemiology/risk factors of sexual dysfunction. J Sex Med. 2004;1:35–9.

    Article  PubMed  Google Scholar 

  31. Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol. 2008;112(5):970–8.

    Article  PubMed  Google Scholar 

  32. McCabe MP, Sharlip ID, Lewis R, Atalla E, Balon R, Fisher AD, et al. Incidence and prevalence of sexual dysfunction in women and men: A Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015. J Sex Med. 2016;13(2):144–52.

    Article  PubMed  Google Scholar 

  33. Hatzichristou D, Kirana PS, Banner L, Althof SE, Lonnee-Hoffmann RA, Dennerstein L, et al. Diagnosing sexual dysfunction in men and women: sexual history taking and the role of symptom scales and questionnaires. J Sex Med. 2016;13(8):1166–82.

    Article  PubMed  Google Scholar 

  34. Kingsberg S, Althof SE. Evaluation and treatment of female sexual disorders. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20 Suppl 1:S33–43.

    Article  PubMed  Google Scholar 

  35. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26(2):191–208.

    Article  CAS  PubMed  Google Scholar 

  36. Clayton AH, McGarvey EL, Clavet GJ. The Changes in Sexual Functioning Questionnaire (CSFQ): development, reliability, and validity. Psychopharmacol Bull. 1997;33(4):731–45.

    CAS  PubMed  Google Scholar 

  37. McGahuey CA, Gelenberg AJ, Laukes CA, Moreno FA, Delgado PL, McKnight KM, et al. The Arizona Sexual Experience Scale (ASEX): reliability and validity. J Sex Marital Ther. 2000;26(1):25–40.

    Article  CAS  PubMed  Google Scholar 

  38. Derogatis L, Clayton A, Lewis-D’Agostino D, Wunderlich G, Fu Y. Validation of the Female Sexual Distress Scale-revised for assessing distress in women with hypoactive sexual desire disorder. J Sex Med. 2008;5(2):357–64.

    Article  PubMed  Google Scholar 

  39. Clayton AH, Segraves RT, Leiblum S, Basson R, Pyke R, Cotton D, et al. Reliability and validity of the Sexual Interest and Desire Inventory-Female (SIDI-F), a scale designed to measure severity of female hypoactive sexual desire disorder. J Sex Marital Ther. 2006;32(2):115–35.

    Article  PubMed  Google Scholar 

  40. Abdo CH. Development and validation of female sexual quotient - A questionnaire to assess female sexual function. Rev Bras Med. 2006;63(9):477–82.

    Google Scholar 

  41. Clayton AH, Goldstein I, Kim NN, Althof SE, Faubion SS, Faught BM, et al. The International Society for the Study of Women’s Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women. Mayo Clin Proc. 2018;93(4):467–87.

    Article  PubMed  Google Scholar 

  42. Nicolosi A, Laumann EO, Glasser DB, Moreira ED Jr, Paik A, Gingell C, et al. Sexual behavior and sexual dysfunctions after age 40: the global study of sexual attitudes and behaviors. Urology. 2004;64:991–7.

    Article  PubMed  Google Scholar 

  43. Polland AR, Davis M, Zeymo A, Iglesia CB. Association between comorbidities and female sexual dysfunction: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Int Urogynecol J. 2018;30:377. https://doi.org/10.1007/s00192-018-3739-7.

    Article  PubMed  Google Scholar 

  44. Atlantis E, Sullivan T. Bidirectional association between depression and sexual dysfunction: a systematic review and meta-analysis. J Sex Med. 2012;9:1497–507.

    Article  PubMed  Google Scholar 

  45. Fabre LF, Smith LC. The effect of major depression on sexual function in women. J Sex Med. 2012;9:231–9.

    Article  PubMed  Google Scholar 

  46. Cyranowski JM, Hofkens TL, Frank E, Seltman H, Cai H-M, Amico JA. Evidence of dysregulated peripheral oxytocin release among depressed women. Psychosom Med. 2008;70:967–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Hartmann U, Philippsohn S, Heiser K, Rüffer-Hesse C. Low sexual desire in midlife and older women: personality factors, psychosocial development, present sexuality. Menopause. 2004;11(6):726–40.

    Article  PubMed  Google Scholar 

  48. Kalmbach DA, Kingsberg SA, Ciesla JA. How changes in depression and anxiety symptoms correspond to variations in female sexual response in a nonclinical sample of young women: a daily diary study. J Sex Med. 2014;11(12):2915–27.

    Article  PubMed  Google Scholar 

  49. Kalmbach DA, Pillai V. Daily affect and female sexual function. J Sex Med. 2014;11(12):2938–54.

    Article  PubMed  Google Scholar 

  50. Khandker M, Brady SS, Vitonis AF, Maclehose RF, Stewart EG, Harlow BL. The influence of depression and anxiety on risk of adult onset vulvodynia. J Women’s Health. 2011;20(10):1445–51.

    Article  Google Scholar 

  51. Kalmbach DA, Ciesla JA, Janata JW, Kingsberg SA. Specificity of anhedonic depression and anxious arousal with sexual problems among sexually healthy young adults. J Sex Med. 2012;9(2):501–13.

    Article  Google Scholar 

  52. Bradford A, Meston CM. The impact of anxiety on sexual arousal in women. Behav Res Ther. 2006;44(8):1067–77.

    Article  PubMed  Google Scholar 

  53. Van Minnen A, Kampman M. The interaction between anxiety and sexual functioning: a controlled study of sexual functioning in women with anxiety disorders. Sex Rel Ther. 2000;15(1):47–57.

    Article  Google Scholar 

  54. Aksaray G, Yelken B, Kaptanoglu C, Oflu S, Ozaltin M. Sexuality in women with obsessive compulsive disorder. J Sex Marital Ther. 2001;27(3):273–7.

    Article  CAS  PubMed  Google Scholar 

  55. Bodinger L, Hermesh H, Aizenberg D, Valevski A, Marom S, Shiloh R, et al. Sexual function and behavior in social phobia. J Clin Psychiatry. 2002;63(10):874–9.

    Article  PubMed  Google Scholar 

  56. Figueira I, Possidente E, Marques C, Hayes K. Sexual dysfunction: a neglected complication of panic disorder and social phobia. Arch Sex Behav. 2001;30(4):369–77.

    Article  CAS  PubMed  Google Scholar 

  57. Leeners B, Hengartner MP, Rossler W, Ajdacic-Gross V, Angst J. The role of psychopathological and personality covariates in orgasmic difficulties: a prospective longitudinal evaluation in a cohort of women from age 30 to 50. J Sex Med. 2014;11(12):2928–37.

    Article  PubMed  Google Scholar 

  58. Nobre P, Pinto-Gouveia J. Emotions during sexual activity: differences between sexually functional and dysfunctional men and women. Arch Sex Behav. 2006;35(4):491–9.

    Article  PubMed  Google Scholar 

  59. Arpana G, Rapkin AJ, Gill Z, Kilpatrick L, Fling C, Stains J, et al. Disease-related differences in resting state networks: a comparison between localized provoked vulvodynia, irritable bowel syndrome, and healthy control subjects. Pain. 2015;156(5):809–19.

    Article  Google Scholar 

  60. Burri A, Ogata S, Williams F. Female sexual pain: epidemiology and genetic overlap with chronic widespread pain. Eur J Pain. 2017;21(8):1408–16.

    Article  CAS  PubMed  Google Scholar 

  61. Donaldson RL, Meana M. Early dyspareunia experience in young women: confusion, consequences, and help-seeking barriers. J Sex Med. 2011;8(3):814–23.

    Article  PubMed  Google Scholar 

  62. Basson R. The recurrent pain and sexual sequelae of provoked vestibulodynia: a perpetuating cycle. J Sex Med. 2012;9(8):2077–92.

    Article  PubMed  Google Scholar 

  63. Desrochers G, Bergeron S, Landry T, Jodoin M. Do psychosexual factors play a role in the etiology of provoked vestibulodynia? A critical review. J Sex Marital Ther. 2008;34(3):198–226.

    Article  PubMed  Google Scholar 

  64. Crisp C, Vaccaro C, Fellner A, Kleeman S, Pauls R. The influence of personality and coping on female sexual function: a population survey. J Sex Med. 2015;12(1):109–15.

    Article  PubMed  Google Scholar 

  65. Fontenelle LF, de Souza WF, de Menezes GB, Mendlowicz MV, Miotto RR, Falcão R, et al. Sexual function and dysfunction in Brazilian patients with obsessive compulsive disorder and social anxiety disorder. J Nerv Ment Dis. 2007;195(3):254–7.

    Article  PubMed  Google Scholar 

  66. Harley EW, Boardman J, Craig T. Sexual problems in schizophrenia: prevalence and characteristics: a cross sectional survey. Soc Psychiatry Psychiatr Epidemiol. 2010;45(7):759–66.

    Article  PubMed  Google Scholar 

  67. Ostman M. Low satisfaction with sex life among people with severe mental illness living in a community. Psychiatry Res. 2014;216(3):340–5.

    Article  PubMed  Google Scholar 

  68. De Boer MK, Castelein S, Wiersma D, Schoevers RA, Knegtering H. The facts about sexual (Dys) function in schizophrenia: an overview of clinically relevant findings. Schizophr Bull. 2015;41(3):674–86.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Montejo AL, Montejo L, Baldwin DS. The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management. World Psychiatry. 2018;17(1):3–11.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Meade CS, Kershaw TS, Hansen NB, Sikkema KJ. Long-term correlates of childhood abuse among adults with severe mental illness: adult victimization, substance abuse, and HIV sexual risk behavior. AIDS Behav. 2009;13(2):207–16.

    Article  PubMed  Google Scholar 

  71. Shevlin M, O’Neill T, Houston JE, Read J, Bentall RP, Murphy J. Patterns of lifetime female victimization and psychotic experiences: a study based on the adult psychiatric morbidity survey. Soc Psychiatry Psychiatr Epid. 2012;48(1):15–24.

    Article  Google Scholar 

  72. Marengo E, Martino DJ, Igoa A, Fassi G, Scápola M, Urtueta Baamonde M, et al. Sexual risk behaviors among women with bipolar disorder. Psychiatry Res. 2015;230(3):835–8.

    Article  PubMed  Google Scholar 

  73. Ellison JM. Exercise-induced orgasms associated with fluoxetine treatment of depression. J Clin Psychiatry. 1996;57(12):596–7.

    Article  CAS  PubMed  Google Scholar 

  74. Clayton A, Kornstein S, Prakash A, Mallinckrodt C, Wohlreich M. Changes in sexual functioning associated with duloxetine, escitalopram, and placebo in the treatment of patients with major depressive disorder. J Sex Med. 2007;4(4 Pt 1):917–29.

    Article  CAS  PubMed  Google Scholar 

  75. Culpepper L, Kovalick LJ. A review of the literature on the selegiline transdermal system: an effective and well-tolerated monoamine oxidase inhibitor for the treatment of depression. J Clin Psychiatry. 2008;10(1):25–30.

    Google Scholar 

  76. Clayton AH, Locklear JC, Svedsater H, McIntyre RS. Sexual functioning in patients with major depressive disorder in randomized placebo-controlled studies of extended release quetiapine fumarate. CNS Spectr. 2014;19(2):182–96.

    Article  PubMed  Google Scholar 

  77. Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the study of Psychotropic-Related Sexual Dysfunction. J Clin Psychiatry. 2001;62(3):10–21.

    CAS  PubMed  Google Scholar 

  78. Pereira VM, Arias-Carrion O, Machado S, Nardi AE, Silva AC. Bupropion in the depression-related sexual dysfunction: a systematic review. CNS Neurol Disord Drug Targets. 2014;13(6):1079–88.

    Article  CAS  PubMed  Google Scholar 

  79. Boyarsky BK, Hirschfeld RM. The management of medication-induced sexual dysfunction. Essent Psychopharmacol. 2000;3(2):39–58.

    Google Scholar 

  80. Baldwin DS. Sexual dysfunction associated with antidepressant drugs. Expert Opin Drug Saf. 2004;3(5):457–70.

    Article  CAS  PubMed  Google Scholar 

  81. Clayton AH, Durgam S, Li D, Chen C, Chen L, Mathews M, et al. Effects of vilazodone on sexual functioning in healthy adults: results from a randomized, double-blind, placebo-controlled, and active-controlled study. Int Clin Psychopharmacol. 2017;32(1):27–35.

    Article  PubMed  Google Scholar 

  82. Jacobsen PL, Mahableshwarkar AR, Palo WA, Chen Y, Dragheim M, Clayton AH. Treatment-emergent sexual dysfunction in randomized trials of vortioxetine for major depressive disorder or generalized anxiety disorder: a pooled analysis. CNS Spectr. 2016;21(5):367–78.

    Article  PubMed  Google Scholar 

  83. Fava M, Dording CM, Baker RA, Mankoski R, Tran QV, Forbes RA, et al. Effects of adjunctive aripiprazole on sexual functioning in patients with major depressive disorder and an inadequate response to standard antidepressant monotherapy: a post hoc analysis of 3 randomized, double-blind, placebo-controlled studies. Prim Care Companion CNS Disord. 2011;13(1):e1–e10.

    Google Scholar 

  84. Grover S, Ghosh A, Sarkar S, Chakrabarti S, Avasthi A. Sexual dysfunction in clinically stable patients with bipolar disorder receiving lithium. J Clin Psychopharmacol. 2014;34(4):475–82.

    Article  CAS  PubMed  Google Scholar 

  85. Bobes J, Garcia-Portilla MP, Rejas J, Hern Ndez G, Garcia-Garcia M, Rico-Villademoros F, et al. Frequency of sexual dysfunction and other reproductive side-effects in patients with schizophrenia treated with risperidone, olanzapine, quetiapine, or haloperidol: the results of the EIRE study. J Sex Marital Ther. 2003;29:125–47.

    Article  CAS  PubMed  Google Scholar 

  86. Chiesa A, Leucci V, Serretti A. Antipsychotics and sexual dysfunction: epidemiology, mechanisms and management. Clin Neuropsychiatry. 2013;10:31–6.

    Google Scholar 

  87. Uçok A, Incesu C, Aker T, Erkoç S. Sexual dysfunction in patients with schizophrenia on antipsychotic medication. Eur Psychiatry. 2007;22:328–33.

    Article  PubMed  Google Scholar 

  88. Montejo AL, Majadas S, Rico-Villademoros F, Llorca G, De La Gándara J, Franco M, et al. Frequency of sexual dysfunction in patients with a psychotic disorder receiving antipsychotics. J Sex Med. 2010;7:3404–13.

    Article  PubMed  Google Scholar 

  89. Sathish Kumar SV, Sinha VK. Comparative study of sexual dysfunction and serum prolactin level associated with olanzapine, risperidone, and clozapine in patients with remitted schizophrenia. Indian J Psychiatry. 2015;57:386–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Malik P, Kemmler G, Hummer M, Riecher-Roessler A, Kahn RS, Fleischhacker WW, et al. Sexual dysfunction in first-episode schizophrenia patients: results from European First Episode Schizophrenia Trial. J Clin Psychopharmacol. 2011;31:274–80.

    Article  PubMed  Google Scholar 

  91. Haddad PM, Wieck A. Antipsychotic-induced hyperprolactinaemia: mechanisms, clinical features and management. Drugs. 2004;64:2291–314.

    Article  CAS  PubMed  Google Scholar 

  92. Knegtering H, van der Moolen AE, Castelein S, Kluiter H, van den Bosch RJ. What are the effects of antipsychotics on sexual dysfunctions and endocrine functioning? Psychoneuroendocrinology. 2003;28 Suppl 2:109–23.

    Article  CAS  PubMed  Google Scholar 

  93. Lee JY, Kim SW, Lee YH, Kang HJ, Kim SY, Bae KY, et al. Factors associated with self-rated sexual function in Korean patients with schizophrenia receiving risperidone monotherapy. Hum Psychopharmacol. 2015;30(6):416–24.

    Article  CAS  PubMed  Google Scholar 

  94. Tenback DE, van Harten PN, Slooff CJ, van Os J, SOHO Study Group. Tardive dyskinesia in schizophrenia is associated with prolactin-related sexual disturbances. Neuropsychopharmacology. 2006;31(8):1832–7.

    Article  CAS  PubMed  Google Scholar 

  95. Aichhorn W, Whitworth AB, Weiss EM, Marksteiner J. Second-generation antipsychotics: is there evidence for sex differences in pharmacokinetic and adverse effect profiles? Drug Saf. 2006;29(7):587–98.

    Article  CAS  PubMed  Google Scholar 

  96. Kirana PS, Papaharitou S, Athanasiadis L, Nakopoulou E, Salpiggidis G, Moysidis K, et al. A conceptual framework for the evolution of sexual medicine and a model for the development of alternative sexual health services: 10-year experience of the Center for Sexual and Reproductive Health. J Sex Med. 2009;6(9):2405–16.

    Article  PubMed  Google Scholar 

  97. Giraldi A, Kristensen E, Sand M. Endorsement of models describing sexual response of men and women with a sexual partner: an online survey in a population sample of Danish adults ages 20-65 years. J Sex Med. 2015;12(1):116–28.

    Article  PubMed  Google Scholar 

  98. Ferenidou F, Kirana PS, Fokas K, Hatzichristou D, Athanasiadis L. Sexual response models: toward a more flexible pattern of women’s sexuality. J Sex Med. 2016;13(9):1369–76.

    Article  PubMed  Google Scholar 

  99. Carvalheira AA, Brotto LA, Leal I. Women’s motivations for sex: exploring the Diagnostic and Statistical Manual, Fourth Edition, Text Revision criteria for hypoactive sexual desire and female sexual arousal disorders. J Sex Med. 2010;7(4 Pt 1):1454–63.

    Article  PubMed  Google Scholar 

  100. Parish SJ, Hahn SR. Hypoactive sexual desire disorder: a review of epidemiology, biopsychology, diagnosis, and treatment. Sex Med Rev. 2016;4(2):103–20.

    Article  PubMed  Google Scholar 

  101. Kingsberg SA, Woodard T. Female sexual dysfunction: focus on low desire. Obstet Gynecol. 2015;125(2):477–86.

    Article  PubMed  Google Scholar 

  102. Nobre PJ, Pinto-Gouveia J. Dysfunctional sexual beliefs as vulnerability factors to sexual dysfunction. J Sex Res. 2006;43(1):68–75.

    Article  PubMed  Google Scholar 

  103. Brotto L, Luria M. Sexual interest/arousal disorder in women. In: Binik YM, Hall KS, editors. Principles and practice of sex therapy. 5th ed. New York: Guilford Press; 2014. p. 17–41.

    Google Scholar 

  104. Brotto LA, Basson R. Group mindfulness-based therapy significantly improves sexual desire in women. Behav Res Ther. 2014;57:43–54.

    Article  PubMed  Google Scholar 

  105. Silverstein RG, Brown AC, Roth HD, Britton WB. Effects of mindfulness training on body awareness to sexual stimuli: implications for female sexual dysfunction. Psychosom Med. 2011;73(9):817–25.

    Article  PubMed  PubMed Central  Google Scholar 

  106. Meston CM, Stanton AM. Treatment of female sexual interest/arousal disorder. In: IsHak WW, editor. The textbook of clinical sexual medicine. Basel: Springer; 2017. p. 155–63.

    Chapter  Google Scholar 

  107. Masters WH, Johnson VE. Human sexual inadequacy. Boston, MA: Ishi Press; 1970.

    Google Scholar 

  108. Pereira VM, Arias-Carrion O, Machado S, Nardi AE, Silva AC. Sex therapy for female sexual dysfunction. Int Arch Med. 2013;6(1):37.

    Article  PubMed  PubMed Central  Google Scholar 

  109. Peixoto MM, Nobre P. Cognitive schemas activated in sexual context: a comparative study with homosexual and heterosexual men and women, with and without sexual problems. Cognitive Ther Res. 2015;39(3):390–402.

    Article  Google Scholar 

  110. Assalian P. Psychological and interpersonal dimensions of sexual function and dysfunction. Arab J Urol. 2013;11(3):217–21.

    Article  PubMed  PubMed Central  Google Scholar 

  111. Montejo-González AL, Llorca G, Izquierdo JA, Ledesma A, Bousoño M, Calcedo A, et al. SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. J Sex Marital Ther. 1997;23(3):176–94.

    Article  PubMed  Google Scholar 

  112. Kennedy SH, Eisfeld BS, Dickens SE, Bacchiochi JR, Bagby RM. Antidepressant-induced sexual dysfunction during treatment with moclobemide, paroxetine, sertraline, and venlafaxine. J Clin Psychiatry. 2000;61(4):276–81.

    Article  CAS  PubMed  Google Scholar 

  113. Clayton AH, Pradko JF, Croft HA, Montano CB, Leadbetter RA, Bolden-Watson C, et al. Prevalence of sexual dysfunction among newer antidepressants. J Clin Psychiatry. 2002;63(4):357–66.

    Article  PubMed  Google Scholar 

  114. Taylor MJ, Rudkin L, Bullemor-Day P, Lubin J, Chukwujekwu C, Hawton K. Strategies for managing sexual dysfunction induced by antidepressant medication. Cochrane Database Syst Rev. 2013;5:CD003382.

    Google Scholar 

  115. Basson R, Brotto LA, Laan E, Redmond G, Utian WH. Assessment and management of women’s sexual dysfunctions: problematic desire and arousal. J Sex Med. 2005;2(3):291–300.

    Article  PubMed  Google Scholar 

  116. Clayton AH, Croft HA, Handiwala L. Antidepressants and sexual dysfunction: mechanisms and clinical implications. Postgrad Med. 2014;126(2):91–9.

    Article  PubMed  Google Scholar 

  117. Graf H, Walter M, Metzger CD, Abler B. Antidepressant-related sexual dysfunction - perspectives from neuroimaging. Pharmacol Biochem Behav. 2014;121:138–45.

    Article  CAS  PubMed  Google Scholar 

  118. Baldwin D, Moreno RA, Briley M. Resolution of sexual dysfunction during acute treatment of major depression with milnacipran. Hum Psychopharmacol. 2008;23(6):527–32.

    Article  PubMed  Google Scholar 

  119. Baldwin D, Bridgman K, Buis C. Resolution of sexual dysfunction during double-blind treatment of major depression with reboxetine or paroxetine. J Psychopharmacol. 2006;20(1):91–6.

    Article  CAS  PubMed  Google Scholar 

  120. Baldwin DS, Palazzo MC, Masdrakis VG. Reduced treatment-emergent sexual dysfunction as a potential target in the development of new antidepressants. Depress Res Treat. 2013;2013:256841.

    PubMed  PubMed Central  Google Scholar 

  121. Clayton AH, Montejo AL. Major depressive disorder, antidepressants, and sexual dysfunction. J Clin Psychiatry. 2006;67 Suppl 6:33–7.

    PubMed  Google Scholar 

  122. Clayton AH, Warnock JK, Kornstein SG, Pinkerton R, Sheldon-Keller A, McGarvey EL. A placebo-controlled trial of bupropion SR as an antidote for selective serotonin reuptake inhibitor-induced sexual dysfunction. J Clin Psychiatry. 2004;65(1):62–7.

    Article  CAS  PubMed  Google Scholar 

  123. Nurnberg HG, Hensley PL, Heiman JR, Croft HA, Debattista C, Paine S. Sildenafil treatment of women with antidepressant-associated sexual dysfunction: a randomized controlled trial. JAMA. 2008;300(4):395–404.

    Article  CAS  PubMed  Google Scholar 

  124. Safarinejad MR, Hosseini SY, Asgari MA, Dadkhah F, Taghva A. A randomized, double-blind, placebo-controlled study of the efficacy and safety of bupropion for treating hypoactive sexual desire disorder in ovulating women. BJU Int. 2010;106(2):832–9.

    Article  CAS  PubMed  Google Scholar 

  125. Clayton AH, Baker RA, Sheehan JJ, Cain ZJ, Forbes RA, Marler SV, et al. Comparison of adjunctive use of aripiprazole with bupropion or selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors: analysis of patients beginning adjunctive treatment in a 52-week, open-label study. BMC Res Notes. 2014;7:459.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  126. Jacobsen PL, Mahableshwarkar AR, Chen Y, Chrones L, Clayton AH. Effect of vortioxetine vs. escitalopram on sexual functioning in adults with well-treated major depressive disorder experiencing SSRI-induced sexual dysfunction. J Sex Med. 2015;12(10):2036–48.

    Article  CAS  PubMed  Google Scholar 

  127. Fooladi E, Bell RJ, Jane F, Robinson PJ, Kulkarni J, Davis SR. Testosterone improves antidepressant-emergent loss of libido in women: findings from a randomized, double-blind, placebo-controlled trial. J Sex Med. 2014;11(3):831–9.

    Article  CAS  PubMed  Google Scholar 

  128. Kulak J Jr. Quando indicar, como realizar e qual a duração da terapêutica androgênica para mulheres na pós-menopausa. In: Wender MC, Pompei LM, Fernandes CE, editors. Consenso brasileiro de terapêutica hormonal da menopausa. São Paulo: Leitura Médica; 2014. p. 111–4.

    Google Scholar 

  129. Lorenz TA, Meston CM. Acute exercise improves physical sexual arousal in women taking antidepressants. Ann Behav Med. 2012;43(3):352–61.

    Article  PubMed  Google Scholar 

  130. Fruhauf S, Gerger H, Schmidt HM. Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis. Arch Sex Behav. 2013;42(6):915–33.

    Article  PubMed  Google Scholar 

  131. Paterson LQ, Handy AB, Brotto LA. A Pilot study of eight-session mindfulness-based cognitive therapy adapted for women’s sexual interest/arousal disorder. J Sex Res. 2017;54(7):850–61.

    Article  PubMed  Google Scholar 

  132. Berghmans B. Physiotherapy for pelvic pain and female sexual dysfunction: an untapped resource. Int Urogynecol J. 2018;29(5):631–8.

    Article  PubMed  PubMed Central  Google Scholar 

  133. Goldstein AT, Pukall CF, Brown C, Bergeron S, Stein A, Kellogg-Spadt S. Vulvodynia: assessment and treatment. J Sex Med. 2016;13:572–90.

    Article  PubMed  Google Scholar 

  134. Sadownik LA, Seal BN, Brotto LA. Provoked vestibulodynia — Women’s experience of participating in a multidisciplinary vulvodynia program. J Sex Med. 2012;9:1086–93.

    Article  PubMed  Google Scholar 

  135. Brotto LA, Yong P, Smith KB, Sadownik LA. Impact of a multidisciplinary vulvodynia program on sexual functioning and dyspareunia. J Sex Med. 2015;12:238–47.

    Article  PubMed  Google Scholar 

  136. Goldfinger C, Pukall CF, Thibault-Gagnon S, McLean L, Chamberlain S. Effectiveness of cognitive-behavioral therapy and physical therapy for provoked vestibulodynia: a randomized pilot study. J Sex Med. 2016;13:88–94.

    Article  PubMed  Google Scholar 

  137. Money J. The concept of gender identity disorder in childhood and adolescence after 39 years. J Sex Marital Ther. 1994;20(3):163–77.

    Article  CAS  PubMed  Google Scholar 

  138. Fausto-Sterling A. Of gender and genitals: the use and abuse of the modern intersexual. In: Fausto-Sterling A, editor. Sexing the body: gender politics and the construction of sexuality. New York: Basic Books; 2000. p. 45–77.

    Google Scholar 

  139. American Psychological Association. Report of the task force on gender identity and gender variance. 2009. Retrieved 18.08.2018 from http://www.apa.org/pi/lgbt/resources/policy/gender-identity-report.pdf.

  140. Fisk N. Gender dysphoria syndrome (the how, what, and why of a disease). In: Laub D, Gandy P, editors. Proceedings of the second interdisciplinary symposium on gender dysphoria syndrome. Palo Alto, CA: Stanford University Press; 1974. p. 7–14.

    Google Scholar 

  141. Herdt G. Third sex, third gender: beyond sexual dimorphism in culture and history. New York: Zone Books; 1994.

    Google Scholar 

  142. Dean J. Gender identity and related disorders. In: Porst H, Reisman Y, editors. ESSM syllabus of sexual medicine 2012. Amsterdam: Medix; 2012. p. 1253–77.

    Google Scholar 

  143. Winter S, Chalungsooth P, Teh Y, Rojanalert N, Maneerat K, Wong Y, et al. Transpeople, transprejudice and pathologization: a seven-country factor analysis study. Int J Sex Health. 2009;21:96–118.

    Article  Google Scholar 

  144. Zucker KJ, Lawrence AA, Kreukels BP. Gender dysphoria in adults. Annu Rev Clin Psychol. 2016;12:217–47.

    Article  PubMed  Google Scholar 

  145. Swaab DF, Garcia-Falgueras A. Sexual differentiation of the human brain in relation to gender identity and sexual orientation. Funct Neurol. 2009;24:17–28.

    PubMed  Google Scholar 

  146. De Cuypere G, Van Hemelrijck M, Michel A, Carael B, Heylens G, Rubens R, et al. Prevalence and demography of transsexualism in Belgium. Eur Psychiatry. 2007;22(3):137–41.

    Article  PubMed  Google Scholar 

  147. Beek TF, Cohen-Kettenis PT, Kreukels BP. Gender incongruence/gender dysphoria and its classification history. Int Rev Psychiatry. 2016;28(1):5–12.

    Article  PubMed  Google Scholar 

  148. Nieder TO, Herff M, Cerwenka S, Preuss WF, Cohen-Kettenis PT, De Cuypere G, et al. Age of onset and sexual orientation in transsexual males and females. J Sex Med. 2011;8(3):783–91.

    Article  PubMed  Google Scholar 

  149. Lawrence AA. Sexual orientation versus age of onset as bases for typologies (subtypes) for gender identity disorder in adolescents and adults. Arch Sex Behav. 2010;39(2):514–45.

    Article  PubMed  Google Scholar 

  150. Wylie K, Knudson G, Khan SI, Bonierbale M, Watanyusakul S, Baral S. Serving transgender people: clinical care considerations and service delivery models in transgender health. Lancet. 2016;388(10042):401–11.

    Article  PubMed  Google Scholar 

  151. Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J, et al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. Int J Transgenderism. 2012;13(4):165–232.

    Article  Google Scholar 

  152. Bockting WO, Coleman E. Developmental stages of the transgender coming out process: toward an integrated identity. In: Ettner R, Monstrey S, Eyler A, editors. Principles of transgender medicine and surgery. New York: The Haworth Press; 2007. p. 185–208.

    Google Scholar 

  153. Clements-Nolle K, Marx R, Mitchell KM. Attempted suicide among transgender persons: the influence of gender-based discrimination and victimization. J Homosex. 2006;51(3):53–69.

    Article  PubMed  Google Scholar 

  154. Hepp U, Kraemer B, Schnyder U, Miller N, Delsignore A. Psychiatric comorbidity in gender identity disorder. J Psychosom Res. 2005;58(3):259–61.

    Article  CAS  PubMed  Google Scholar 

  155. Nuttbrock L, Hwahng S, Bockting W, Rosenblum A, Mason M, Macri M, et al. Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons. J Sex Res. 2010;47(1):12–23.

    Article  PubMed  Google Scholar 

  156. Khobzi Rotondi N, Bauer GR, Travers R, Travers A, Scanlon K, Kaay M. Depression in male-to-female transgender Ontarians: results from the trans PULSE project. Can J Commun Ment Health. 2011;30(2):113–33.

    Article  Google Scholar 

  157. Budge SL, Adelson JL, Howard KA. Anxiety and depression in transgender individuals: the roles of transition status, loss, social support, and coping. J Consult Clin Psychol. 2013;81(3):545–57.

    Article  PubMed  Google Scholar 

  158. Dhejne C, Lichtenstein P, Boman M, Johansson AL, Långström N, Landén M. Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden. PLoS One. 2011;6(2):e16885.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  159. Smith YL, Van Goozen SH, Kuiper AJ, Cohen-Kettenis PT. Sex reassignment: outcomes and predictors of treatment for adolescent and adults transsexuals. Psychol Med. 2005;35(1):89–99.

    Article  PubMed  Google Scholar 

  160. Gorin-Lazard A, Baumstarck K, Boyer L, Maquigneau A, Gebleux S, Penochet JC, et al. Is hormonal therapy associated with better quality of life in transsexuals? A cross-sectional study. J Sex Med. 2012;9(2):531–41.

    Article  PubMed  Google Scholar 

  161. Gómez-Gil E, Zubiaurre-Elorza L, Esteva I, Guillamon A, Godás T, Cruz Almaraz M, et al. Hormone-treated transsexuals report less social distress, anxiety and depression. Psychoneuroendocrinology. 2012;37(5):662–70.

    Article  PubMed  CAS  Google Scholar 

  162. Hembree WC, Cohen-Kettenis P, Delemarre-van de Waal HA, Gooren LJ, Meyer WJ 3rd, Spack NP, et al. Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2009;94:3132–54.

    Article  CAS  PubMed  Google Scholar 

  163. Wylie KR, Fung R Jr, Boshierd C, Rotchell M. Recommendations of endocrine treatment for patients with gender dysphoria. Sex Relationship Ther. 2009;24:175–87.

    Article  Google Scholar 

  164. Gooren LJ. Clinical practice. Care of transsexual persons. N Engl J Med. 2011;364:1251–7.

    Article  CAS  PubMed  Google Scholar 

  165. De Roo C, Tilleman K, T’Sjoen G, De Sutter P. Fertility options in transgender people. Int Rev Psychiatry. 2016;28(1):112–9.

    Article  PubMed  Google Scholar 

  166. Wallien MSC, Cohen-Kettenis PT. Psychosexual outcome of gender-dysphoric children. J Am Acad Child Adolesc Psychiatry. 2008;47:1413–23.

    Article  PubMed  Google Scholar 

  167. Steensma TD, McGuire JK, Kreukels BP, Beekman AJ, Cohen-Kettenis PT. Factors associated with desistence and persistence of childhood gender dysphoria: a quantitative follow-up study. J Am Acad Child Adolesc Psychiatry. 2013;52:582–90.

    Article  PubMed  Google Scholar 

  168. de Vries AL, McGuire JK, Steensma TD, Wagenaar EC, Doreleijers TA, Cohen-Kettenis PT. Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics. 2014;134:696–704.

    Article  PubMed  Google Scholar 

  169. Thornton J. Working with the transgender voice: the role of the speech and language therapist. Theol Sex. 2008;17:271–6.

    Google Scholar 

  170. Parker AJ. Aspects of transgender laryngeal surgery. Theol Sex. 2008;17:277–82.

    Google Scholar 

  171. Cornelisse VJ, Jones RA, Fairley CK, Grover SR. The medical care of the neovagina of transgender women: a review. Sex Health. 2017;14(5):442–50.

    Article  PubMed  Google Scholar 

  172. Monstrey SJ, Ceulemans P, Hoebeke P. Sex reassignment surgery in the female-to-male transsexual. Semin Plast Surg. 2011;25:229–44.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry, University of São Paulo, School of Medicine, São Paulo, Brazil

    Carmita H. N. Abdo

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Editors and Affiliations

  1. University of São Paulo, São Paulo, Brazil

    Joel Rennó Jr.

  2. Women’s Mental Health Clinic, Incestuous Families Treatment Clinic of Clinica’s Hospital, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil

    Gislene Valadares

  3. Federal University of Pernambuco, Recife, Pernambuco, Brazil

    Amaury Cantilino

  4. Brazilian Association of Psychiatry, Rio de Janeiro, Brazil

    Jeronimo Mendes-Ribeiro

  5. Private Practice, São Lucas Medical Institute Criciúma, Santa Catarina, Brazil

    Renan Rocha

  6. Brazilian Association of Psychiatry (ABP), Rio de Janeiro, Brazil

    Antonio Geraldo da Silva

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Abdo, C.H.N. (2020). Sexual Dysfunctions and Gender Dysphoria in Women. In: Rennó Jr., J., Valadares, G., Cantilino, A., Mendes-Ribeiro, J., Rocha, R., Geraldo da Silva, A. (eds) Women's Mental Health. Springer, Cham. https://doi.org/10.1007/978-3-030-29081-8_12

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