medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-16-10-17medsovet-7076Research ArticleРЕПРОДУКТИВНОЕ ЗДОРОВЬЕ И ВРТREPRODUCTIVE HEALTH AND ARTСнижение полового влечения у женщин: пути решения проблемыHypoactive sexual desire disorders in women: ways to solve the problemhttps://orcid.org/0000-0002-8657-5002ФедороваА. И.FedorovaA. I.

Анна Игоревна Федорова, д. м. н., доцент, профессор

кафедра психотерапии, медицинской психологии и сексологии

191015

ул. Кирочная, д. 41

Санкт- Петербург

Anna I. Fedorova, Dr. Sci. (Med.), Professor

Department of Psychotherapy, Medical Psychology and Sexology

191015

41, Kirochnaya St.

St Petersburg

feanna@inbox.ruСеверо-Западный государственный медицинский университет имени И. И. МечниковаРоссияNorth-Western State Medical University named after I. I. MechnikovRussian Federation2022061020220161017Copyright © Федорова А.И., 20222022Федорова А.И.Fedorova A.I.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7076

   В последние десятилетия женщины все чаще обращаются к врачам различного профиля с проблемами сниженного полового влечения (СПВ). Женское либидо рассматривают как один из важных показателей качества жизни, сексуального здоровья. Терапия СПВ затруднена из-за недостаточных знаний врачами как сложных, множественных патогенетических механизмов снижения либидо, так и современных терапевтических подходов. В данной статье женское половое влечение рассматривается с точки зрения биопсихосоциального подхода, признанного ведущим при работе с сексуальными дисфункциями. В соответствии с ним СПВ является следствием сочетанных нарушений на различных уровнях функционирования человека (соматическом, личностно-психологическом и индивидо-социальном). Представлены современные концептуальные модели полового влечения, на основе которых разрабатываются терапевтические подходы к СПВ. Обсуждены наиболее эффективные с доказательной точки зрения направления терапии СПВ у женщин – устранение биомедицинских факторов, нарушающих либидо, психотерапевтические мероприятия (сексуальное информирование, когнитивно-поведенческая терапия (КПТ), сексуальная терапия). Приведены доказательные исследования, подтверждающие высокую эффективность интегративного комбинированного подхода к терапии СПВ, объединяющего сексуальное информирование, КПТ, сексуальную терапию и фармакотерапию. Представлен новый российский препарат – пептид, созданный специально для лечения СПВ у женщин. Препарат прошел все стадии клинических испытаний и может использоваться как при лечении идиопатического СПВ, так и в составе комбинированной терапии (в комплексе с психотерапевтическими, секстерапевтическими мероприятиями).

In recent decades, women are increasingly contact the doctors with problems of hypoactive sexual desire disorders (HSDD). Female libido is considered as one of the important indicators of quality of life, sexual health. Therapy of HSDD is difficult due to insufficient knowledge by doctors of both complex, multiple pathogenetic mechanisms of libido reduction and modern therapeutic approaches. In this article, the female sexual desire is considered from the point of view of the biopsychosocial approach, recognized as the leading one when working with sexual dysfunctions. According to biopsychosocial approach, HSDD is a consequence of combined disorders at various levels of human functioning (somatic, personal-psychological and individual-social). Modern conceptual models of sexual desire are presented, on the basis of which therapeutic approaches to HSDD are developed. The most effective from the evidence point of view directions of therapy of HSDD in women – elimination of biomedical factors that violate libido, psychotherapeutic measures (sexual awareness, cognitive behavioral therapy, sexual therapy) are discussed. Evidence-based studies confirming the high effectiveness of an integrative approach to the therapy of HSDD, combining sexual awareness, CBT, sexual therapy and pharmacotherapy, are presented. A new Russian drug – a peptide created specifically for the treatment of HSDD in women is presented. The drug has passed all stages of clinical trials and can be used both in the treatment of idiopathic HSDD and as part of combine therapy (in combination with psychotherapy and sextherapy).

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The authors declare that there are no conflicts of interest present.