Female Sexual Dysfunction - 2005 physician survey
Scope
Report Highlights
Reasons to Purchase
Table of Contents
- ABOUT DATAMONITOR HEALTHCARE - page 2
- About the Women's Health pharmaceutical analysis team - page 2
- CHAPTER 1 EXECUTIVE SUMMARY - page 3
- Scope of the analysis - page 3
- Datamonitor insight into the FSD market - page 4
- There is a low level of satisfaction with currently available classification diagnostic guidelines for FSD - page 4
- Presentation by women with sexual functioning problems is limited by a number of factors including 'embarrassment', lack of physician awareness and education and a need for a referral process/direct access to specialists - page 5
- There is both space and a significant unmet need for a formally approved product or products for female sexual dysfunction - page 6
- CHAPTER 2 INTRODUCTION AND SCOPE - page 9
- Scope and objectives - page 9
- Breakdown of the Stakeholder Opinions Survey - page 10
- Limitations - page 11
- CHAPTER 3 COUNTRY TREATMENT TREES - page 13
- CHAPTER 4 EPIDEMIOLOGY AND PATIENT SEGMENTATION - page 20
- Introduction - page 21
- Theories of female sexual response - page 21
- Masters and Johnson's linear model - page 21
- Kaplan's revision - page 22
- Criticisms of early models - page 23
- Circular model: Whipple and Brash-McGreer after Reed - page 23
- Basson's non-linear model - page 24
- Disease definition and classification - page 26
- Classifications and diagnostic criteria of FSD - page 26
- ICD-10 - page 26
- DSM-IV - page 27
- AFUD - page 29
- Limitations of classifications - page 30
- Classifications and diagnostic criteria of FSD - page 26
- Epidemiology of FSD from secondary published research - page 32
- Inherent difficulties in assessing prevalence of FSD - page 32
- Country-specific epidemiological estimates - page 33
- US National Health and Social Life Survey: widely quoted but open to criticism - page 34
- FSD increases with age in Japanese women - page 36
- FSD highly prevalent in young German women - page 37
- FSD extensively studied in UK - page 37
- The Global Study of Sexual Attitudes and Behaviors - page 39
- Epidemiology of FSD according to Datamonitor's physician survey - page 43
- FSD subtypes - page 47
- Sexual pain disorder - page 48
- Niche populations and co-morbid conditions - page 50
- Partners with erectile dysfunction - page 52
- Depression and antidepressants - page 52
- Cardiovascular disease - page 54
- Diabetes - page 54
- Postpartum - page 55
- Unmet need in FSD - page 56
- Need for improved tools for assessment and diagnosis - page 56
- Need for objective measures for FSD - page 57
- Need for an approved therapy for FSD - page 58
- Need for investment in supporting services and clear referral pathway - page 59
- Need for physician education - page 59
- FSD subtypes - page 47
- CHAPTER 5 DIAGNOSIS AND TREATMENT OPTIONS - page 61
- Presentation and diagnosis - page 62
- Presentation and referral patterns - page 62
- Help-seeking behavior and barriers to presentation - page 63
- Let's talk about sex...or not. - page 66
- Sexual dysfunction as a primary versus secondary complaint - page 69
- Top 10 symptoms and complaints reported at initial presentation - page 70
- Screening practices - page 72
- Who to screen? - page 75
- Diagnosis, guidelines and satisfaction with classification systems - page 78
- Guidelines for diagnosis - page 79
- How useful are FSD diagnostic guidelines in clinical practice? - page 83
- Presentation and diagnosis - page 62
- CHAPTER 6 PRESCRIBING TRENDS AND INFLUENCING FACTORS - page 85
- Treatment options - page 86
- Physicians responsible for the treatment of FSD - page 86
- Treatment rates - page 88
- Non-drug therapy options - page 90
- The importance of counseling - page 90
- Counseling and therapy most prevalent in US - page 92
- Fewer non-drug options in UK - page 92
- Devices and lubricants favored over education in Spain - page 92
- FDA-approved devices - page 93
- Hypoactive sexual desire disorder - page 93
- Therapeutic approach - drug versus non-drug treatment - page 93
- Drug treatment - monotherapy versus combinations - page 97
- HSDD drug treatment breakdown - page 97
- Female sexual arousal disorder - page 100
- Therapeutic approach - drug versus non-drug treatment - page 100
- Drug treatment - monotherapy versus combinations - page 104
- FSAD drug treatment breakdown - page 104
- Non-drug therapy options - page 90
- Treatment options - page 86
- BIBLIOGRAPHY - page 107
- APPENDIX A - page 110
- Physician research methodology - page 110
- Physician sample breakdown - page 110
- US - page 110
- France - page 110
- Germany - page 111
- Italy - page 111
- Spain - page 111
- UK - page 112
- Contributing experts - page 112
- Physician research methodology - page 110
- APPENDIX B - page 114
- THE SURVEY QUESTIONNAIRE - page 114
- 1. EPIDEMIOLOGY - page 114
- 2. SCREENING AND DIAGNOSIS - page 118
- 3. TREATMENT PRACTICES - page 128
- 3.1 General treatment approach to female sexual dysfunction - page 128
- 3.2. Case study - Hypoactive sexual desire disorder (HSDD) and female sexual arousal disorder (FSAD) - page 132
- 3.3 Testosterone therapy for low libido (hypoactive sexual desire disorder) - page 141
- Disclaimer - page 145
- List of Tables
- Table 1: Prevalence of sexual dysfunction and help-seeking behavior in the US - NHSLS data (%), 1999 - page 35
- Table 2: US prevalence of FSD based on NHSLS data, 2005 - page 35
- Table 3: UK prevalence of FSD by subtype in women aged 18-75 years - page 38
- Table 4: GSSAB prevalence of female sexual problems by region (%), 2005 - page 40
- Table 5: Prevalence of low desire in women aged 40-80 years based on GSSAB data, 2005 - page 41
- Table 6: Prevalence of lack of orgasm in women aged 40-80 years based on GSSAB data, 2005 - page 41
- Table 7: Prevalence of sexual pain in women aged 40-80 years based on GSSAB data, 2005 - page 42
- Table 8: Prevalence of arousal problems in women aged 40-80 years based on GSSAB data, 2005 - page 42
- Table 9: Percentage of premenopausal patients experiencing each sexual dysfunction subtype in the US, UK, Spain and Germany/Italy/France, 2005 - page 47
- Table 10: Percentage of postmenopausal patients experiencing each sexual dysfunction subtype in the US, UK, Spain and Germany/Italy/France, 2005 - page 48
- Table 11: Estimated proportion of patients with sexual functioning problems with co-morbid conditions and potential risk factors in the US, UK and Spain (%), 2005 - page 50
- Table 12: Percentage of pre- and post-menopausal women presenting directly and being referred to respondents for their sexual functioning problems by country, 2005 - page 62
- Table 13: Percentage of pre- and post-menopausal women presenting directly and being referred to respondents for their sexual functioning problems by respondent type in the US , UK, Spain and Germany/Italy/France, 2005 - page 63
- Table 14: Top 10 factors cited by respondents as preventing women who are experiencing sexual problems from seeking help in the US , UK, Spain and Germany/Italy/France, 2005 - page 66
- Table 15: Percentage of premenopausal and postmenopausal patients experiencing sexual dysfunction as a primary versus secondary complaint by country, 2005 - page 69
- Table 16: Percentage of premenopausal and postmenopausal patients experiencing sexual dysfunction as a primary versus secondary complaint by respondent type in the US , UK, Spain and Germany/Italy/France, 2005 - page 70
- Table 17: Percentage of respondents reporting the most common complaints with sexual functioning at presentation by country, 2005 - page 71
- Table 18: Respondent satisfaction with current FSD classification systems by region, 2005 - page 84
- Table 19: Physician specialties responsible for the treatment of FSD in sampled countries in the US, UK, Spain and Germany/Italy/ France, 2005 - page 87
- Table 20: Percentage of patients with FSD receiving each treatment approach by country and region, 2005 - page 89
- Table 21: Breakdown of treatment received by premenopausal patients with HSDD by region (%), 2005 - page 94
- Table 22: Breakdown of treatment received by postmenopausal women with HSDD by region (%), 2005 - page 95
- Table 23: Percentage of premenopausal and postmenopausal HSDD patients receiving mono or combination prescription drug therapy by region, 2005 - page 97
- Table 24: Premenopausal HSDD drug treatment by drug class in the US , UK, Spain and Germany/Italy/France (%), 2005 - page 98
- Table 25: Breakdown of drug prescribing in the premenopausal HSDD population by country and region (%), 2005 - page 98
- Table 26: Percentage of postmenopausal HSDD patients receiving each drug therapy option by country and region, 2005 - page 99
- Table 27: Breakdown of treatment received by premenopausal patients with FSAD by country (%), 2005 - page 101
- Table 28: Breakdown of treatment received by postmenopausal patients with FSAD by country (%), 2005 - page 102
- Table 29: Percentage of premenopausal and postmenopausal FSAD patients receiving mono or combination prescription drug therapy by region, 2005 - page 104
- Table 30: Percentage of premenopausal FSAD patients receiving each drug therapy option by country and region, 2005 - page 105
- Table 31: Percentage of postmenopausal FSAD patients receiving each drug therapy option by country and region, 2005 - page 106
- Table 32: US physician sample breakdown, 2005 - page 110
- Table 33: France physician sample breakdown, 2005 - page 110
- Table 34: Germany physician sample breakdown, 2005 - page 111
- Table 35: Italy physician sample breakdown, 2005 - page 111
- Table 36: Spain physician sample breakdown, 2005 - page 111
- Table 37: UK physician sample breakdown, 2002 - page 112
- List of Figures
- Figure 1: Sample breakdown by respondent type -Stakeholder Opinions survey: FSD, 2005 - page 10
- Figure 2: Number of respondents per country - Stakeholder Opinions survey: FSD, 2005 - page 11
- Figure 3: US: treatment pathway for HSDD among the premenopausal and postmenopausal clinical population, 2005 - page 14
- Figure 4: US: treatment pathway for FSAD among the premenopausal and postmenopausal clinical population, 2005 - page 15
- Figure 5: UK: treatment pathway for HSDD among the premenopausal and postmenopausal clinical population, 2005 - page 16
- Figure 6: UK: treatment pathway for FSAD among the premenopausal and postmenopausal clinical population, 2005 - page 17
- Figure 7: Spain: treatment pathway for HSDD among the premenopausal and postmenopausal clinical population, 2005 - page 18
- Figure 8: Spain: treatment pathway for FSAD among the premenopausal and postmenopausal clinical population, 2005 - page 19
- Figure 9: Basson's model of female sexual functioning - page 24
- Figure 10: Overview of some of the key limitations of existing FSD classification systems and their implications - page 30
- Figure 11: Breakdown of respondent's female patient population by menopausal status in the US, UK, Spain and Germany/Italy/France, 2005 - page 43
- Figure 12: Percentage of patients experiencing some degree of sexual functioning problems in the US, UK, Spain and Germany/Italy/France, 2005 - page 44
- Figure 13: Breakdown of patients with sexual functioning problems by menopausal status in the US, UK, Spain and Germany/Italy/France (%), 2005 - page 45
- Figure 14: Prevalence of female patients experiencing more than one sexual dysfunction in the US, UK, Spain and Germany/Italy/France (%), 2005 - page 46
- Figure 15: Breakdown of sexual pain in premenopausal patients by pain subtype and country in the US, UK, Spain and Germany/Italy/France (%), 2005 - page 49
- Figure 16: Breakdown of sexual pain in postmenopausal patients by pain subtype and country in the US, UK, Spain and Germany/Italy/France (%), 2005 - page 49
- Figure 17: Estimated percentage of patients with sexual functioning problems who are reported to also suffer from other conditions in the US, UK and Spain, 2005 - page 51
- Figure 18: Summary of most significant barriers to presentation or help-seeking for sexual functioning problems among women in the US, UK, Spain and Germany/Italy/France, 2005 - page 64
- Figure 19: Top 10 reported symptoms or complaints presented by patients in the US and Europe, 2005 - page 71
- Figure 20: Percentage of respondents who conduct routine screening for sexual functioning problems by country and physician specialty, 2005 - page 73
- Figure 21: Percentage of female patients screened for sexual dysfunction by respondents who carry out routine screening by country, 2005 - page 75
- Figure 22: Percentage of patients screened for FSD by respondents, by co-morbid or associated condition in the US, UK, Spain and Germany/Italy/France, 2005 - page 77
- Figure 23: Summary of evaluation tools and techniques used to diagnose FSD among all respondents in the US, UK, Spain and Germany/Italy/France, 2005 - page 78
- Figure 24: Mean percentage of all respondents using various guidelines in the US, UK, Spain and Germany/Italy/France, 2005 - page 80
- Figure 25: Mean percentage of respondents reporting use of each diagnostic guideline in the US, 2005 - page 80
- Figure 26: Mean percentage of respondents reporting use of each diagnostic guideline in Spain, 2005 - page 81
- Figure 27: Mean percentage of respondents reporting use of each diagnostic guideline in the UK, 2005 - page 82
- Figure 28: FSD treatment options - page 86
- Figure 29: Average percentage of female patients with sexual dysfunction receiving each treatment approach by region, 2005 - page 88
- Figure 30: Percentage of patients receiving non-drug therapy options for female sexual dysfunction by country, 2005 - page 91
- Figure 31: Treatment of premenopausal HSDD by therapeutic approach and country (%), 2005 - page 94
- Figure 32: Treatment of postmenopausal HSDD by therapeutic approach and country (%), 2005 - page 96
- Figure 33: Treatment of premenopausal FSAD by therapeutic approach and country (%), 2005 - page 101
- Figure 34: Treatment of postmenopausal FSAD by therapeutic approach and country (%), 2005 - page 103
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