OBJECTIVES: To understand the unmet needs related to the diagnosis and management of patients with hypoactive sexual desire disorder (HSDD).

METHODS: Data from 268 medical charts from US board-certified obstetricians/gynecologists (OB/GYNs), psychiatrists, and primary care physicians (PCPs, including family and internal medicine physicians) were collected using an IRB-approved case report form that mimicked a typical patient chart. Physicians also answered an IRB-approved web-based questionnaire. Physicians who treated/managed ≥2 patients diagnosed with HSDD and ≥5 patients diagnosed with female sexual dysfunction (FSD) each month were included. Medical charts for females ≥18 years old who had been diagnosed with HSDD were included.

RESULTS: The 103 physicians who contributed medical charts included OB/GYNs (41%), PCPs (31%), and psychiatrists (28%); 16% reported a subspecialty in sexual medicine. Medical charts for premenopausal (57%) and postmenopausal patients (43%) were included; their mean age was 45 years. The HSDD patient journey was characterized at presentation, diagnosis, treatment, and posttreatment. At each stage of the patient journey, physicians discussed and reported a similar set of HSDD symptoms. Questions about hallmark symptoms of HSDD, including little to no desire to engage in sexual activity and distress associated with low sexual desire, were only asked ≤25% of the time at all stages. Approximately 25% of the time, physicians did not inquire about any symptoms and did not discuss the evolution of symptoms across all stages. Notably, patients with comorbid conditions, including depression and anxiety, experienced approximately 2 years of delay in HSDD diagnosis.

CONCLUSIONS: Physicians and patients discussed a similar set of symptoms throughout the HSDD patient journey, indicating an infrequent dialogue that delays the diagnosis of HSDD. In the clinical practice setting, more education is needed to help physicians initiate the clinical conversation with patients at the early stages of the patient journey and to appropriately identify the symptoms.