medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-063medsovet-7447Research ArticleРЕПРОДУКТИВНОЕ ЗДОРОВЬЕ И ВРТREPRODUCTIVE HEALTH AND ARTРегуляция женского сексуального поведения и возможности медикаментозной терапииRegulation of female sexual behavior and possibilities of drug therapyhttps://orcid.org/0000-0002-9916-6128КозловП. В.KozlovP. V.

Козлов Павел Васильевич, д.м.н., врач – акушер-гинеколог, профессор кафедры акушерства и гинекологии лечебного факультета,

117997, Москва, ул. Островитянова, д. 1

Pavel V. , Kozlov, Dr. Sci. (Med.), Obstetrician-Gynecologist, Professor of the Department of Obstetrics and Gynecology, Faculty of Medicine, 

1, Ostrovityanov St., Moscow, 117997

drkpv@mail.ruРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian Federation202318042023051520Copyright © Козлов П.В., 20232023Козлов П.В.Kozlov P.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7447

Женское половое поведение находится под сложным влиянием психологических, нейроэндокринных и социальных факторов. Реализация нормальной сексуальной активности у большинства женщин возможна при соблюдении многих условий и в первую очередь при обеспечении позитивного психоэмоционального фона, безопасности, удовлетворительного состояния здоровья, а также комфортных межличностных отношений. Помимо значимого психологического и социального влияния, накопленные современные научные данные подтверждают важную роль нейрогормональной регуляции сексуального поведения и предполагают потенциальную эффективность фармакологической терапии. Однако медикаментозные стратегии коррекции женских сексуальных расстройств, к сожалению, ограничены. В настоящее время в некоторых странах разрешены к применению несколько препаратов, повышающих женскую сексуальную активность, однако все они не зарегистрированы и не одобрены к применению на территории Российской Федерации. В статье кратко изложены нейронные механизмы основных областей центральной нервной системы, лежащие в основе восприимчивости и сексуального влечения, а именно обонятельной и лимбической системы, неокортекса. Основное внимание уделено функции нейромедиаторов и гормонов, критически участвующих в модуляции эмоций и полового поведения, в том числе тормозящего медиатора гамма-аминомасляной кислоты (ГАМК), эстрогенов, тестостерона, возбуждающего медиатора глутамата. Подробно представлены этапы разработки, результаты экспериментальных и  клинических исследований по  оценке эффективности и безопасности у пациенток со снижением или утратой сексуального влечения уникального российского нейропептидного препарата Дизайрикс, являющегося стимулятором сексуального поведения благодаря механизму обратимого подавления ГАМК-эргической системы, неспецифической стимуляции дофаминергической системы мотивации и подкрепления положительных эмоций и растормаживания контролирующей функции неокортекса. 

Female sexual behavior is under the complex influence of psycho-emotional, neuroendocrine and social factors. The realization of normal sexual activity in women is possible if many conditions are met and, first of all, ensuring a positive psycho-emotional background, safety, a satisfactory state of health, as well as comfortable interpersonal relationships for most women. In addition to significant psychological and social impact, accumulated modern scientific data confirm the important role of neuro-hormonal regulation of sexual behavior and suggest the potential effectiveness of pharmacological therapy. Unfortunately, however, medical strategies for correcting female sexual disorders are limited. Currently, in some countries, several drugs that increase female sexual activity are allowed for use, however, all of them are not registered and are not approved for use on the territory of the Russian Federation. The article briefly describes the neural mechanisms of the main areas of the central nervous system underlying receptivity and sexual attraction, namely the olfactory and limbic systems, the neocortex. The main attention is paid to the function of neurotransmitters and hormones that are critically involved in the modulation of emotions and sexual behavior, including the inhibitory mediator of gamma aminobutyric acid (GABA), estrogens, testosterone, and the excitatory mediator glutamate. The stages of development, the results of experimental and clinical studies to assess the effectiveness and safety of the unique Russian neuropeptide drug Desirex, which is a stimulant of sexual behavior due to the mechanism of reversible suppression of the GABAergic system, nonspecific stimulation of the dopaminergic system of motivation and reinforcement of positive emotions and disinhibition of the controlling function of the neocortex, are presented in detail. 

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