Stakeholder Opinions: Female Sexual Dysfunction

Results from Datamonitor's 2005 physician survey

Publication Date	June 2007
Publisher	Datamonitor
Product Type	Report
Pages	149
ISBN Number	not applicable
Product Code	DAT05883

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Summary

Introduction

Patients in a clinical population receive drug and non-drug therapy for female sexual dysfunction, yet a third remain refractory to treatment, highlighting a need for a formally approved product for FSD. There is a low level of satisfaction with the classification guidelines, further limiting diagnosis, already hampered by embarrassment, lack of physician awareness and an unclear referral system.

Scope

Review of the disease definition, classification and key patient segmentation for female sexual dysfunction
Assessment of the current unmet needs in the treatment of female sexual dysfunction
Exploration of the screening, presentation and referral patterns within the female sexual dysfunction population in the 5EU and US
Prescription and treatment trends among important subcategories of female sexual dysfunction, such as hypoactive sexual desire disorder (HSDD)

Highlights

Testosterone therapies are already widely used among women with hypoactive sexual desire disorder and female sexual arousal disorder. There is a significant market for a formally approved testosterone product for women, with 85% of prescribers willing to switch existing testosterone users onto an approved product.

There is a distinct need for more specialized services in support of those with sexual functioning problems. There is no clear referral pathway for primary care physicians and no specialist service for patients to present directly to. This causes a barrier to presentation, diagnosis and treatment.

The identification and classification of FSD is biased by physician's perception. A woman presenting with sexual difficulties could receive a variety of diagnoses or even no diagnosis at all. There is a need not only for a more holistic approach to sexual dysfunction, but also for validated and consistent tools to assess and diagnose patients.

Reasons to Purchase

Understand key opinion leaders views on topical issues in the female sexual dysfunction market
View quantified, pictorial treatment pathways of female sexual dysfunction patients in the UK, US and Spain
Examine treatment trends for female sexual dysfunction subtypes, hypoactive sexual desire disorder and female sexual arousal disorder

Content

Chapter 1 Executive Summary
- Scope Of The Analysis
- Datamonitor Insight Into The Fsd Market
- There Is A Low Level Of Satisfaction With Currently Available Classification Diagnostic Guidelines For Fsd
- 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
- There Is Both Space And A Significant Unmet Need For A Formally Approved Product Or Products For Female Sexual Dysfunction
Chapter 2 Introduction And Scope
- Scope And Objectives
- Breakdown Of The Stakeholder Opinions Survey
- Limitations
Chapter 3 Country Treatment Trees
Chapter 4 Epidemiology And Patient Segmentation
- Introduction
- Theories Of Female Sexual Response
- Masters And Johnson's Linear Model
- Kaplan's Revision
- Criticisms Of Early Models
- Circular Model: Whipple And Brash-Mcgreer After Reed
- Basson's Non-Linear Model
- Disease Definition And Classification
- Classifications And Diagnostic Criteria Of Fsd
- Icd-10
- Dsm-Iv
- Afud
- Limitations Of Classifications
- Epidemiology Of Fsd From Secondary Published Research
- Inherent Difficulties In Assessing Prevalence Of Fsd
- Country-Specific Epidemiological Estimates
- Us National Health And Social Life Survey: Widely Quoted But Open To Criticism
- Fsd Increases With Age In Japanese Women
- Fsd Highly Prevalent In Young German Women
- Fsd Extensively Studied In Uk
- The Global Study Of Sexual Attitudes And Behaviors
- Epidemiology Of Fsd According To Datamonitor's Physician Survey
- Fsd Subtypes
- Sexual Pain Disorder
- Niche Populations And Co-Morbid Conditions
- Partners With Erectile Dysfunction
- Depression And Antidepressants
- Cardiovascular Disease
- Diabetes
- Postpartum
- Unmet Need In Fsd
- Need For Improved Tools For Assessment And Diagnosis
- Need For Objective Measures For Fsd
- Need For An Approved Therapy For Fsd
- Need For Investment In Supporting Services And Clear Referral Pathway
- Need For Physician Education
Chapter 5 Diagnosis And Treatment Options
- Presentation And Diagnosis
- Presentation And Referral Patterns
- Help-Seeking Behavior And Barriers To Presentation
- Let's Talk About Sex...Or Not.
- Sexual Dysfunction As A Primary Versus Secondary Complaint
- Top 10 Symptoms And Complaints Reported At Initial Presentation
- Screening Practices
- Who To Screen?
- Diagnosis, Guidelines And Satisfaction With Classification Systems
- Guidelines For Diagnosis
- How Useful Are Fsd Diagnostic Guidelines In Clinical Practice?
Chapter 6 Prescribing Trends And Influencing Factors
- Treatment Options
- Physicians Responsible For The Treatment Of Fsd
- Treatment Rates
- Non-Drug Therapy Options
- The Importance Of Counseling
- Counseling And Therapy Most Prevalent In Us
- Fewer Non-Drug Options In Uk
- Devices And Lubricants Favored Over Education In Spain
- Fda-Approved Devices
- Hypoactive Sexual Desire Disorder
- Therapeutic Approach - Drug Versus Non-Drug Treatment
- Drug Treatment - Monotherapy Versus Combinations
- Hsdd Drug Treatment Breakdown
- Female Sexual Arousal Disorder
- Therapeutic Approach - Drug Versus Non-Drug Treatment
- Drug Treatment - Monotherapy Versus Combinations
- Fsad Drug Treatment Breakdown
Bibliography
Appendix A
- Physician Research Methodology
- Physician Sample Breakdown
- Us
- France
- Germany
- Italy
- Spain
- Uk
- Contributing Experts
Appendix B
The Survey Questionnaire
- 1. Epidemiology
- 2. Screening And Diagnosis
- 3. Treatment Practices
- 3.1 General Treatment Approach To Female Sexual Dysfunction
- 3.2. Case Study - Hypoactive Sexual Desire Disorder (Hsdd) And Female Sexual Arousal Disorder (Fsad)
- 3.3 Testosterone Therapy For Low Libido (Hypoactive Sexual Desire Disorder)
- Disclaimer
List Of Tables
- Table 1: Prevalence Of Sexual Dysfunction And Help-Seeking Behavior In The Us - Nhsls Data (%), 1999
- Table 2: Us Prevalence Of Fsd Based On Nhsls Data, 2005
- Table 3: Uk Prevalence Of Fsd By Subtype In Women Aged 18-75 Years
- Table 4: Gssab Prevalence Of Female Sexual Problems By Region (%), 2005
- Table 5: Prevalence Of Low Desire In Women Aged 40-80 Years Based On Gssab Data, 2005
- Table 6: Prevalence Of Lack Of Orgasm In Women Aged 40-80 Years Based On Gssab Data, 2005
- Table 7: Prevalence Of Sexual Pain In Women Aged 40-80 Years Based On Gssab Data, 2005
- Table 8: Prevalence Of Arousal Problems In Women Aged 40-80 Years Based On Gssab Data, 2005
- Table 9: Percentage Of Premenopausal Patients Experiencing Each Sexual Dysfunction Subtype In The Us, Uk, Spain And Germany/Italy/France, 2005
- Table 10: Percentage Of Postmenopausal Patients Experiencing Each Sexual Dysfunction Subtype In The Us, Uk, Spain And Germany/Italy/France, 2005
- 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
- Table 12: Percentage Of Pre- And Post-Menopausal Women Presenting Directly And Being Referred To Respondents For Their Sexual Functioning Problems By Country, 2005
- 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
- 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
- Table 15: Percentage Of Premenopausal And Postmenopausal Patients Experiencing Sexual Dysfunction As A Primary Versus Secondary Complaint By Country, 2005
- 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
- Table 17: Percentage Of Respondents Reporting The Most Common Complaints With Sexual Functioning At Presentation By Country, 2005
- Table 18: Respondent Satisfaction With Current Fsd Classification Systems By Region, 2005
- Table 19: Physician Specialties Responsible For The Treatment Of Fsd In Sampled Countries In The Us, Uk, Spain And Germany/Italy/ France, 2005
- Table 20: Percentage Of Patients With Fsd Receiving Each Treatment Approach By Country And Region, 2005
- Table 21: Breakdown Of Treatment Received By Premenopausal Patients With Hsdd By Region (%), 2005
- Table 22: Breakdown Of Treatment Received By Postmenopausal Women With Hsdd By Region (%), 2005
- Table 23: Percentage Of Premenopausal And Postmenopausal Hsdd Patients Receiving Mono Or Combination Prescription Drug Therapy By Region, 2005
- Table 24: Premenopausal Hsdd Drug Treatment By Drug Class In The Us , Uk, Spain And Germany/Italy/France (%), 2005
- Table 25: Breakdown Of Drug Prescribing In The Premenopausal Hsdd Population By Country And Region (%), 2005
- Table 26: Percentage Of Postmenopausal Hsdd Patients Receiving Each Drug Therapy Option By Country And Region, 2005
- Table 27: Breakdown Of Treatment Received By Premenopausal Patients With Fsad By Country (%), 2005
- Table 28: Breakdown Of Treatment Received By Postmenopausal Patients With Fsad By Country (%), 2005
- Table 29: Percentage Of Premenopausal And Postmenopausal Fsad Patients Receiving Mono Or Combination Prescription Drug Therapy By Region, 2005
- Table 30: Percentage Of Premenopausal Fsad Patients Receiving Each Drug Therapy Option By Country And Region, 2005
- Table 31: Percentage Of Postmenopausal Fsad Patients Receiving Each Drug Therapy Option By Country And Region, 2005
- Table 32: Us Physician Sample Breakdown, 2005
- Table 33: France Physician Sample Breakdown, 2005
- Table 34: Germany Physician Sample Breakdown, 2005
- Table 35: Italy Physician Sample Breakdown, 2005
- Table 36: Spain Physician Sample Breakdown, 2005
- Table 37: Uk Physician Sample Breakdown, 2002
List Of Figures
- Figure 1: Sample Breakdown By Respondent Type -Stakeholder Opinions Survey: Fsd, 2005
- Figure 2: Number Of Respondents Per Country - Stakeholder Opinions Survey: Fsd, 2005
- Figure 3: Us: Treatment Pathway For Hsdd Among The Premenopausal And Postmenopausal Clinical Population, 2005
- Figure 4: Us: Treatment Pathway For Fsad Among The Premenopausal And Postmenopausal Clinical Population, 2005
- Figure 5: Uk: Treatment Pathway For Hsdd Among The Premenopausal And Postmenopausal Clinical Population, 2005
- Figure 6: Uk: Treatment Pathway For Fsad Among The Premenopausal And Postmenopausal Clinical Population, 2005
- Figure 7: Spain: Treatment Pathway For Hsdd Among The Premenopausal And Postmenopausal Clinical Population, 2005
- Figure 8: Spain: Treatment Pathway For Fsad Among The Premenopausal And Postmenopausal Clinical Population, 2005
- Figure 9: Basson's Model Of Female Sexual Functioning
- Figure 10: Overview Of Some Of The Key Limitations Of Existing Fsd Classification Systems And Their Implications
- Figure 11: Breakdown Of Respondent's Female Patient Population By Menopausal Status In The Us, Uk, Spain And Germany/Italy/France, 2005
- Figure 12: Percentage Of Patients Experiencing Some Degree Of Sexual Functioning Problems In The Us, Uk, Spain And Germany/Italy/France, 2005
- Figure 13: Breakdown Of Patients With Sexual Functioning Problems By Menopausal Status In The Us, Uk, Spain And Germany/Italy/France (%), 2005
- Figure 14: Prevalence Of Female Patients Experiencing More Than One Sexual Dysfunction In The Us, Uk, Spain And Germany/Italy/France (%), 2005
- Figure 15: Breakdown Of Sexual Pain In Premenopausal Patients By Pain Subtype And Country In The Us, Uk, Spain And Germany/Italy/France (%), 2005
- Figure 16: Breakdown Of Sexual Pain In Postmenopausal Patients By Pain Subtype And Country In The Us, Uk, Spain And Germany/Italy/France (%), 2005
- 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
- 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
- Figure 19: Top 10 Reported Symptoms Or Complaints Presented By Patients In The Us And Europe, 2005
- Figure 20: Percentage Of Respondents Who Conduct Routine Screening For Sexual Functioning Problems By Country And Physician Specialty, 2005
- Figure 21: Percentage Of Female Patients Screened For Sexual Dysfunction By Respondents Who Carry Out Routine Screening By Country, 2005
- 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
- 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
- Figure 24: Mean Percentage Of All Respondents Using Various Guidelines In The Us, Uk, Spain And Germany/Italy/France, 2005
- Figure 25: Mean Percentage Of Respondents Reporting Use Of Each Diagnostic Guideline In The Us, 2005
- Figure 26: Mean Percentage Of Respondents Reporting Use Of Each Diagnostic Guideline In Spain, 2005
- Figure 27: Mean Percentage Of Respondents Reporting Use Of Each Diagnostic Guideline In The Uk, 2005
- Figure 28: Fsd Treatment Options
- Figure 29: Average Percentage Of Female Patients With Sexual Dysfunction Receiving Each Treatment Approach By Region, 2005
- Figure 30: Percentage Of Patients Receiving Non-Drug Therapy Options For Female Sexual Dysfunction By Country, 2005
- Figure 31: Treatment Of Premenopausal Hsdd By Therapeutic Approach And Country (%), 2005
- Figure 32: Treatment Of Postmenopausal Hsdd By Therapeutic Approach And Country (%), 2005
- Figure 33: Treatment Of Premenopausal Fsad By Therapeutic Approach And Country (%), 2005
- Figure 34: Treatment Of Postmenopausal Fsad By Therapeutic Approach And Country (%), 2005