Rosemary Basson

UBC Departments of Psychiatry and Obstetrics & Gynaecology, B.C. Centre for Sexual Medicine, Vancouver General Hospital, Vancouver, BC, Canada

Introduction 44

Reasons Women Initiate or Accept Sexual Activity with Their Partners 45 Model of Sexual Response Showing Various Incentives and Motivations to Be Sexual and Arousal triggering and Accompanying Desire 46

Sexual Arousablity 48

Traditional Markers of Sexual Desire 48 Assessment of Low Desire/Interest and the Associated Low Arousability to Identify Therapeutic Options 48 A Closer Look at the Biological Basis of Women's Sexual Desire and

Arousability Including the Role of Androgens 50 Management of Low Desire/Interest: Psychological, Pharmacological, and Biopsychosocial Approach 53

Psychological Treatments 53

Nonhormonal Pharmacological Treatment of Low Desire/Interest 55

Hormonal Treatment 55

Testosterone 55

Tibolone 56

A Biopsychosocial Approach to Therapy 56

Recommendations for Clinical Practice

Conclusion

References

57 59 59

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