Was ist HSDD (Hypoactive Sexual Desire Disorder, Störung mit vermindertem sexuellen Verlangen)?

 

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Zusammenfassung

Hypoactive Sexual Desire Disorder (HSDD) ist die häufigste Form der FSD (Female Sexual Dysfunction, sexuelle Dysfunktion bei Frauen) und die am häufigsten anzutreffende sexuelle Funktionsstörung der Frau in der klinischen Praxis. HSDD ist charakterisiert durch mangelnde/s oder fehlende/s sexuelle Fantasien und Verlangen nach Sex, was ein ausgeprägtes Leiden und zwischenmenschliche Probleme verursacht, die nicht eher auf eine andere psychiatrische Störung, medizinische Erkrankung oder einen Wirkstoff (z. B. Medikamente) zurückzuführen sind. HSDD tritt bei Frauen jeden Alters und sowohl bei prä- als auch postmenopausalen Frauen auf. Die Pathophysiologie von HSDD ist bisher nicht genau erforscht, aber man geht davon aus, dass auf neurobiologischer Ebene ein Ungleichgewicht der inhibitorischen und exzitatorischen Faktoren vorliegt, die das sexuelle Verlangen im Gehirn steuern. HSDD führt zu einer geringeren sexuellen und partnerschaftlichen Zufriedenheit und ist mit einem hohen emotionalen Leidensdruck assoziiert. Aufgrund fehlender Fachkenntnisse, fehlender effektiver Therapien oder zeitlicher Einschränkungen scheuen sich viele Ärzte, sexuelle Störungen bei ihren Patienten anzusprechen. Frauenärzte sollten sich diesem wichtigen Problem annehmen. Der Decreased Sexual Desire Screener (DSDS®) ist ein kurzes diagnostisches Instrument, das für Ärzte, die keine Experten für FSD sind, eine rasche und einfache Methode darstellt, eine generalisierte, erworbene HSDD bei Frauen zu diagnostizieren. Gegenwärtig sind die Behandlungsangebote für Frauen mit HSDD begrenzt, für die meisten Frauen mit HSDD ist wahrscheinlich ein mehrdimensionaler Ansatz am wirksamsten.

Abstract

Hypoactive Sexual Desire Disorder (HSDD) is the most common form of FSD (Female Sexual Dysfunction) and the most common sexual disorder in women in clinical practice. HSDD is defined as a deficiency or absence of sexual fantasies and of the desire for sexual activity with a great impact on interpersonal relationships which cannot be attributed to other causes such as psychiatric or medical illnesses or the effect of particular drugs. Both pre- and postmenopausal women may be affected by HSDD. The pathophysiology of HSDD is not known in any detail; the current scientific opinion is that it may be due to a neurobiological imbalance in the inhibitory and excitatory factors which control sexual desire in the brain. HSDD leads to reduced sexual and interpersonal satisfaction and is associated with high emotional psychological strain. Gynecologists should be first persons to whom women affected with HSDD should be able to turn, but due to the lack of specialist training, time, and effective therapy many doctors shy away from broaching the topic. The Decreased Sexual Desire Screener (DSDS®) is a short and simple diagnostic tool for the detection of HSDD by non-specialist colleagues. As the range of therapies currently available to women with HSDD is limited, multidimensional treatments should be offered to women with HSDD.

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Dr. med. Gert Naumann

Klinik und Poliklinik für Geburtshilfe und Frauenkrankheiten
Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Körperschaft des öffentlichen Rechts

Langenbeckstraße 1

55131 Mainz

Email: gnaumann@uni-mainz.de