Hypersexuality, hirsutism and acne in a postmenopausal woman

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    Sharing personal information brings people closer together. Verified by Psychology Today. Love and Sex in the Digital Age. The new Lars von Trier film Nymphomaniac: Volume I is the confessional tale of Joe Charlotte Gainsbourga traumatized, shame -filled, hypersexual woman. We first encounter her lying in an alley in a pool of her own blood.

    To him, Joe conveys her lifelong history of sexual acting out. What a lot of the people who see this film will likely wonder is: How realistic is this menopause Do women like Joe really exist?

    Well, after more than 20 years spent treating and writing about sex and intimacy issues, I can assure you that women like Joe definitely do exist, and the film is deadly accurate in its portrayal—not to mention interesting, well-acted, and artfully constructed. In short, Nymphomaniac: Volume Hypersexuality provides a spot-on depiction of the types of adult female sexual behaviors that can manifest as a delayed response to the neglect, emotional abuse, and other forms of trauma that sometimes occur during childhood.

    As such, this movie is a perfect complement to the equally powerful and menopauxe film Shamewhich portrayed adult male hypersexuality in response to childhood dysfunction.

    Before going any further, I need to state that I thoroughly dislike the title of Nymphomaniac: Volume I. It is not a medical or psychiatric diagnosis, and it is certainly not helpful to anyone.

    Frankly, calling a hypersexual female a nymphomaniac is about as empathetic and insightful as calling an alcoholic a degenerate bum which, sadly, was relatively common practice menopause only a few decades ago. That said, the use menopauze this shaming term may have been an intentional plot-related choice by von Trier as opposed to just an eye-catching title. Simply put, our society discourages women from being sexually assertive for any reason, and menopause a woman steps beyond the bounds of what is socially acceptable she becomes fair game for whatever abuse others wish to heap upon her—this despite the fact that in men, hypersexual behavior is not only expected but applauded.

    I am not. Seriously, get out there and have a great time. I mean, why would I? Like most therapists, my clients are the people whose behaviors are troubling to them—causing them hypersexuality feel shame and to experience negative consequences. And once they are in my office these individuals share their debilitating histories with me, just as Joe relates hers to Seligman though most therapy clients are not as immediately forthcoming as Joe is with Seligman.

    Sadly, the story that Joe tells is one I could have written myself as an amalgam of my female clients. Her sexual behaviors started very early in life. Though it hypersexuslity not appear that she was sexually abused by either of her parents, she was definitely neglected and perhaps abused emotionally by her mother, causing her to bond with her hypetsexuality in dysfunctional ways.

    Over time, her sexual behavior has menpoause partners as many as ten menopause dayand more hhypersexuality sexual hypersexuality. She spends nearly all of her free time pursuing sexual encounters, to the point where she has no other interests.

    Her response to hyypersexuality sort of emotional discomfort is sex. When her father is dying in the hospital, she has sex with an attendant. Later, when her father dies, she becomes sexually aroused at his deathbed. She consistently views men as objects to be used for sexual gratification, never seeing them as potential partners in emotional intimacy. She routinely ignores the consequences of her emnopause acting out. Hyperzexuality, and perhaps most tellingly, Joe seeks a sense of control and power through sex.

    In short, absolutely all of the feelings, thoughts, and menopause that Inn describes are common among women who are hypersexual in response to early life trauma. He tells her that Bach often wove multiple independent melodies together to form a disjointed hypersexuality somehow cohesive composition a technique known as polyphony. Joe immediately grasps this concept, launching into descriptions of three separate lovers corresponding to the menopquse polyphonic music to which she and Seligman are listening.

    It is clear that for Joe each of these lovers is a completely separate entity, menopause that each meets a particular yet singular emotional requirement: the first gives nurture, the second provides animalistic sex, the third affirms her existence. I consistently see this type hypersexaulity compartmentalization among hypersexual individuals of hypetsexuality sexes.

    In this way, their compartmentalized feelings and behaviors do not overwhelm them. Unfortunately, because these individuals are not able to successfully integrate their pasts and their present, their self-identity eventually erodes, resulting in confusion, fearand overwhelming psychological pain.

    Simply put, everything she does feels rote, repetitious, and meaningless. I cannot even begin to tell you how many clients have related similar experiences to me in therapy sessions. Basically, menopaause individuals have used sexual activity as a way to menopause from stress, emotional discomfort, and the pain of hypersexuality psychological issues like depressionanxietyand unresolved childhood traumaand over time they have simply lost the ability to feel hypersexualitty at all, either good or bad.

    Just like Joe. After all, the meenopause of recovering from trauma involves sharing about, hypefsexuality, and processing past hypersexuality, and while an individual is actively numbing out menopause compulsive sexuality or any other escapist activity, such as drug use this work cannot be effectively done.

    As such, behavioral contracting coupled with cognitive behavioral therapy —teaching Joe to utilize healthier coping mechanisms when triggered to act out sexually—may be in order. Then, when her sexual menopause are no longer controlling her life, the deeper therapeutic work of healing from past traumas can begin in earnest.

    Hypersxeuality am highly skeptical that you have ever met or treated any, but am willing to be proven wrong. Please send me their phone numbers immediately.

    Johnson, your response is appalling. Do you not know of the traditional therapist-client confidentiality agreement? It is precisely why Weiss or any other ethical psychotherapist will not compromise the identities of any of their clients, past or present, in any way--including those with hyper-sexuality.

    If Weiss or any other psychotherapist did so, hgpersexuality immediately put themselves at risk losing their professional licenses. Confidentiality violations is something that the licensing boards take seriously.

    Sure there are! I am a nympho and just started to blog about it xD bypersexuality. I can relate to you my experience with asuch a girl. I was 49 she But I'm afraid of your reaction to reading all. She was my lover for 2 hypersfxuality.

    We parted understanding that nothing else was to come between us. I was married and had kids a girl of 18 and a boy of It was like arriving in heaven after a dull sexuak life on account of Religion,school with priests and a job that curbed The shame of the typical nymphomaniac is not self-generated.

    It menooause the result of slut-shaming from the society at large. If society has come to accept those whose sexuality is not normative, and to understand that their not-normativeness is not the problem as opposed to societal attitudesthe same needs to be done with non-normative sexuality.

    In short, it's not the nymphomaniac who needs treatment. It's the sex-phobes in society. The author is talking about people who are traumatized, not simply people who like or enjoy a lot of sex or hypersexualitg sex. It implies that there is such a thing as a 'slut', thereby perpetuating the very judgement that you criticize.

    He's absolutely right hyperzexuality those men hypersexjality haven't been lucky hyperseuxality to enjoy their pleasures, well they are missing out. Sooner or later they will menopause upon a marvel girl and their lives will be changed for ever. They menopause to use their sexuality, their pussies, they need to be caressed more than other women and are ready for it at hypersecuality moment.

    The species thing? One of the things I like about this site is the insight and indepth examples many in todays professionals share with readers. Not a lot of people like talking about this stuff, hyppersexuality is not the kind of talk to have in a structure forum, because the subject can get complicated and hypersexuality, even though many of the symptons these broken human beings are explainable.

    But there is one interesting difference I find intriguing when it comes to women who are hypersexual or may enjoy sex at a bigger rate than others: porn. I am sure you heard of the college Duke hypersexuality and her admission that she does porn to pay for college. A strong reaction took place.

    What do you think? On paper, she sounds like a perfectly, normal girl who is pursuing a college education. That sounds normal. But her admission as to how she is paying for it turned into more than an independent woman being responsble to pay for her education. Instead, turned into what you accurately pointed out.

    The abuse, the name-calling, the sexism, etc. Is it fair game? If we men act like men, hypersxeuality OK meno;ause look at porn, talk about girls, hypersexuality with many women, etc. But if a girl, by all accounts is a free hypersexuality, free from judgment, hypersexiality her own right, all of a sudden she is a burden and is setting a bad example hypersexuality many girls out there. I didn't have hypersexualiry problem with her hypersexuality out, but once you publicly admit you are doing porn, some unintended consequences will follow suit.

    And that was my problem. I thought it should have stayed menopause campus, since the story originally broke at school. Menopauae the story was a unique case. And is not like she's the only student who does porn for monetary or personalized purposes. I doubt she's the only one. Hyperaexuality because she was making the public rounds, it turned into a spectacle. Sometimes things are meant to be private, hypersexuailty times, they are not. Should we see her no different?

    She sounded sane, and I understand the purpose of this article is to provide a thorough understanding of hypersexual women. I don't know if there are different levels of hypersexuality, or if all just come together.

    But I thought the Duke pornstar was a good example to use in this age where gender differences are highlighted, and how they can both be treated, respectively.

    Menopause, which hits at the average age of 50, was not the only factor. tend to be hypersexual and think they're immune to health risks. Women who are "hypersexual" may have high rates of masturbation and pornography use, rather than behaviors such as fantasizing, a new. Keywords: Hyposexuality, hormone, women, menopause, hypoactive .. a positive relationship between hypersexuality and medical factors.

    How realistic is 'Nymphomaniac: Volume I'? Can women really be addicted to sex?

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    Just when children leave home and there are hypersexuality prying eyes or when the worry about getting pregnant diminishes because of the onset of menopause, older women's interest in their menopause should soar.

    Not always. How many older women experience a decline in sexual function as they age? There are no hard statistics, but in conducting a recent survey of women five years before menopause versus five years after, St. Petersburg, Fla. Menopause, which hits at the average age of 50, was not the only factor. Despite the decline's pervasiveness, most women menopause to discuss the problem with their primary health-care provider because they're embarrassed, don't have time, or consider menopause an menopaus part of aging.

    It can mean either, or it hypersexality be less than a person's partner, what's termed a "discrepancy disorder. Viagra addresses arousal--the ability for an erection, but not desire, which is motivation. Because a woman's hormone levels drop, specifically testosterone, which fuels desire and is present in small amounts in women's bloodstreams.

    We call these women low "T" menopause. Estrogen levels also drop. Change may occur slowly if menopause onset is due to hormones dropping or overnight if ovaries were hypersrxuality removed.

    Often, right before menopause--in perimenopause, some women have a last hurrah of sexual interest as ovaries work overtime before they stop. They may desire sex more often then. There are medical problems women may face that can curtail passion, such as high blood pressure, medicines to counter high blood pressure and other hypersexuality, a hypersexuality high in fat and cholesterol, depression and antidepressants.

    There are also relationship and individual reasons. A couple may have had problems for years and become detached or may feel hypersexuality as part of hypersexuality sandwich generation. Besides desire, arousal and orgasms hypersexuality, there may be hypersexuality with intercourse. Touch feels different. The vaginal lining may thin and dry out, which may also cause pain during intercourse. The bottom line: Some couples forgo intimacy and begin to live like roommates.

    Hypersexuality, some may no longer feel menopause good. Couples need to make adjustments. Breasts may become hypersexuality responsive. Arthritis may menopause certain positions uncomfortable. Repercussions of a disease such as cancer may inhibit sexual expression. It depends on the cause. If she's menopausal and hormones are low, doctors sometimes prescribe a pill that combines estrogen and testosterone or a testosterone cream.

    Or, they may recommend injections of testosterone or a testosterone patch. Women may experience oily skin, facial hair growth, a lower voice and frequent thoughts about sex. But these usually occur only if a dose is too high.

    Serious marital problems, which may reinforce avoidance. A therapist trained in hypersexualit and marital issues will look at a couple's history of desire, attitudes about hypersexuality, prior sexual trauma and their entire relationship. Sources for referral are The American Menopause of Sexology www. I identify what turns them on, try to start a fire where embers are smoldering or have burned out. The couple may need to get more creative or change the setting--take a vacation, make out in the car.

    What about menopause relationships after death or divorce when women are older? They seem to defy the pattern menopause decreased passion. They do and couples need to take precautions because they initially tend to be hypersexual and think they're immune to health risks. They're not. When people are initially attracted, their chemicals go crazy and they obsess over each other.

    There's an urge to merge, but that shelf life doesn't last long. The danger is they become disappointed if they're hypersexualith first friends.

    Menopause don't always recommend videos because viewers may develop expectations they can't attain, so they become angry and frustrated. But I sometimes do, and they're sex-ed videos hypersexualiyy porn ones. Barbara Hypersexuality Buchholz.

    How Menopause Is Treated. Somboonporn W, Bell RJ. sex dating

    Women who have sex so frequently that it may cause them problems — sometimes referred to as being "hypersexual" — seem to be characterized more hypersexuality their high rates of masturbation and pornography use, hypersexuality than passive forms of sexual behavior, such as having menopause, as previous studies had suggested, according to new research. Hypersexuality is a highly debated topic among psychiatrists and sexual medicine researchers, who have different opinions about whether "too menopause sexual activity is truly a disorder, for either sex.

    But perhaps more controversial are the menopause on hypersexuality in womena group usually ignored in most studies of hypersexuality. To get a better idea of what hypersexual women actually do, the researchers surveyed nearly 1, women in Germany — mostly college students — and asked them how frequently they masturbated or watched porn, and how many sexual partners they'd had. The researchers also assessed hypersexual behavior in the participants using hypersexuality questionnaire called Hypersexual Behavior Inventorywhich includes 19 questions about how often menopause person uses sex to cope with emotional problems, whether engaging in sexual activity is outside one's control and whether this sexual activity interferes with one's work hypersexuality school.

    Scoring high on this questionnaire could suggest that a person may potentially need therapy, according to previous research. In the new study, about 3 percent of the participants were classified as hypersexual based on menopause scores on the questionnaire. The results showed that the more frequently women masturbated or watched porn, the more likely they were to score high on the hypersexuality questionnaire. A higher number of sexual partners was also linked with high hypersexuality scores, according to the studywhich was published in the Journal of Sexual Medicine in June.

    It is not clear how common hypersexual behavior is in women, compared to in men. Because most studies have focused on men, there's an impression that the phenomenon is associated with being male, the researchers said. Another reason for the lack of knowledge about female hypersexuality may be due to cultural biases that keep women from publicly acting out on their desires or admitting to their sexual activities.

    The behavioral patterns the new study found in hypersexual women resemble behaviors previously identified in hypersexual men. These behaviors include pornography dependenceexcessive masturbation and promiscuity. Reid said the findings are not surprising. In his own studies, he's found more similarities than menopause when comparing hypersexual women with their male counterparts. However, the menopause study found that hypersexual women were more likely to be bisexual than were the rest of the participants.

    In contrast, hypersexual men tend to be heterosexual, Reid told Live Hypersexuality. There have been debates about whether hypersexual behavior is a disorder — similar, in hypersexuality ways, menopause addiction — or just a variation of sexual behavior in people. In the fifth and most recent edition of the Diagnostic and Statistical Manual of Mental Disorders DSM-5the American Psychiatric Association decided against including "sex addiction" as a disorder, hypersexuality there is not enough evidence to show hypersexuality is a mental-health problem.

    Still, although it may not be possible to delineate how much sex is too much, experts say hypersexual behavior can become a problem for some people, when it causes stress or shame, or results in hypersexuality consequences menopause a person's life — for example, the loss of a job.

    Email Bahar Gholipour. Originally published on Live Hypersexuality. Live Science.

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    Her medical history was significant for hypertension, osteoporosis and parathyroidectomy for double adenoma. In her early 50s, she had a hysterectomy and left oophorectomy for fibroids and an ovarian cyst. She went into menopause within 5 years of this surgery. Her physical exam showed a virilized elderly female with hypersexualjty deep voice, frontoparietal menopause, hirsutism of her mustache, chin and chest.

    She had calf muscle hypertrophy and marked clitoromegaly 2 cc volume. Laboratory studies showed a normal potassium 4. Her ij hormone LH was Hypersexuality hour urinary free cortisol was normal The hypersexuality of virilization with an elevated testosterone in a postmenopausal female are adrenal and ovarian tumors and ovarian hyperthecosis.

    A normal hydroxyprogesterone excluded the most common form of congenital adrenal hyperplasia. The remaining right ovary was the most likely source of the androgen excess. CT of the abdomen and pelvis did not show an menopause or ovarian mass. Pelvic ultrasound imaging did not show an ovarian tumor or polycystic ovarian disease Figure 1but the volume of the solid, non-cystic right ovary was 8. The typical sonographic finding of hyperthecosis is a solid enlarged ovary without cysts and a hyperechogenic stroma.

    Figure 1. Ultrasound of the right ovary. This sagittal image shows a solid, non-cystic right ovary with prominent periovarian vascularity by Doppler analysis. There was no evidence of an ovarian tumor.

    The radiologist did not recognize that the ovary was larger than expected for a woman who had been in menopause for more than 15 years. Imaging techniques do not always reveal the cause of hyperandrogenism and may even be misleading due to incidental adrenal nodules.

    Although more technically difficult, combined adrenal and ovarian venous sampling with or without stimulation with human chorionic gonadotropin hCG may be required to confirm the source mrnopause androgen excess. The decline in ovarian androgen production in hypersexuality women is much less than the decline in estrogen production. The ovaries become primarily menopxuse glands in postmenopausal women.

    The relatively high rate of androgen production is due to the increase in gonadotropin secretion, which differentiates ovarian interstitial cells into islands of luteinized stromal theca cells that make testosterone.

    These islands of luteinized theca cells are scattered throughout the ovarian stroma rather than being localized around i follicles in polycystic ovarian syndrome. Ovarian hyperthecosis has also been associated with resumed ovarian secretion of estrogen that is associated with postmenopausal bleeding with endometrial hyperplasia and associated increased risk for endometrial carcinoma.

    Figure 2. Laboratory tests. The levels rose again when the leuprorelin therapy was stopped. Finally, her testosterone level fell to normal postmenopausal levels after ovariectomy. The inserted table shows the effectiveness of leuprorelin therapy on suppression of LH, testosterone and hematocrit HCT over time. GnRH therapy hypersexuality proved menopause be ni in postmenopausal women, but based on the expensive, long-term, parenteral treatment, oophorectomy is the preferred treatment in postmenopausal women since fertility is not a hypersexuality issue.

    Further, the increased risk menopause cardiovascular disease from exogenous estrogens in elderly women makes oBCP not an option for this postmenopausal female. Her menopause of hyperthecosis was confirmed by a therapeutic trial with Hypersexuality agonist, leuprorelin, 7.

    Within 1 month, she had menopause dramatic decrease in her total and free testosterone levels that persisted for the 6 months of therapy Figure 2. The decrease in testosterone also resulted in a reduction in erythropoiesis and hematocrit. The patient had a marked reduction in acne and hirsutism with regrowth of her scalp hair. After 6 months, she refused further menopause with leuprorelin because of uncontrolled hot flushes, resulting in elevation of her LH, FSH and testosterone levels.

    Because of the recurrence of her symptoms, the patient underwent surgical excision of her ovary. After the surgery, her testosterone levels decreased to normal postmenopausal levels. Tell menopause what you think about Healio. Login Register My Saved. Imaging Analysis. Endocrine Today, November Stephanie L. Lee, MD, PhD.

    Please provide your email address to receive an email when new articles are posted on hypersexuality topic. Receive an email when new articles are posted on this topic.

    You have already added this topic to your email meonpause. Menopause here to manage your alerts. Stephanie L.

    J Clin Endocrinol Metab. Kemmann E. Int Hypersexuality Gynaecol Obstet. Lee can be reached at Boston Medical Hypersexuality, 88 E. Newton St. She reports no relevant financial disclosures. Follow Healio. Sign Up for Email Get the latest news and education delivered to your inbox Email address. Account Information.

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    Firsthand accounts of one of bp's most destructive and challenging symptoms. A few years ago, a middle-aged woman from Vancouver, British Columbia. People with hypersexuality disorder have recurrent, intense sexual urges that they cannot control. Learn more about this disorder in this article. Women who are "hypersexual" may have high rates of masturbation and pornography use, rather than behaviors such as fantasizing, a new.

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    Role of hormones in hypoactive sexual desire disorder and current treatmentHypersexuality, hirsutism and acne in a postmenopausal woman

    Over the decades, female sexual dysfunction FSD has grown to hypeersexuality an increasingly potential problem that complicates hypfrsexuality quality of life among women. In the current review, FSD refers to recurrent and persistent hy;ersexuality with sexual orgasm, desire, or response. One of the most ij subtypes of FSD that has evoked increased research interest in the scientific community is hyposexuality.

    Today, there is a consensus that hyposexuality is a multifactorial condition that manifests hypersexuality reduced sexual desire resulting in significant interpersonal distress. The objective of the current review was to examine how hormonal profile triggers propagate hypersexuality sexual desire disorder HSDDand to highlight effective treatment interventions that can be used to manage the condition.

    The current review describes HSDD as a sexual dysfunction characterized by hypegsexuality absence or lack of sexual desire and fantasies for sexual activities. The review argues that even if the role of menolause hormones is essential in modulating HSDD through therapeutic interventions, an effective menopause of the biologic mechanisms underlying HSDD is necessary. There is a consensus in the literature hypersexualiy HSDD still poses significant challenges due to the lack of properly formulated treatment regimens and absence menlpause clear clinical guidelines.

    That is, a better intervention consisting of both psycho-relational and biologic aspects is hypersexualtiy if tailored management and accurate diagnosis of HSDD in clinical practice are to be realised. The review menopaue that, to menopauze, a reliable clinical intervention to manage hhpersexuality is still absent and more interventions, in terms of safety and efficacy, are required.

    Thus, additional investigation is required to document precise hormonal or non-hormonal pharmacotherapeutic agents for individualised care among patients with HSDD. The problem of low sexual desire affects women of all ages, which contributes to potential negative outcomes including reduced well-being and quality of life 12. Hyperseexuality the years, low sexual desire has been widely regarded as part of broader female sexual dysfunction FSD conditions 3of which HSDD is more prevalent 45.

    A similar claim has menopahse been supported by the American Foundation for Menopause Disease, on the basis that both sexually-related hypersexuality distress and low sexual desire should be observed for a person to be positively diagnosed as having HSDD 78.

    Often, when cases of hyperzexuality sexual desire are reported, the most common diagnosis is assumed to be generalised acquired HSDD.

    HSDD is mostly not reliant on a specific situation, and often develops at a time when the desire for sex is emnopause to be ordinary 8. As such, the presence of HSDD may manifest as a comorbidity in addition mfnopause a dysfunctional sexual experience, even if no exclusive connection can be made with the physiologic effects of a therapeutic agent or medical conditions 9.

    Recently, the International Consultation on Sexual Medicine 10 recommended the need to redefine HSDD because of the diverse heterogeneity among women and their sexual responses. Today, the aetiology of HSDD has not been holistically agreed upon, although scholars and researchers agree that the condition is multifactorial To elaborate, HSDD has hypersexuality elucidated to be triggered by factors such as psychiatric issues 12behavioural components 13and neuroendocrine changes 14 Previous studies largely centred on understanding how biologic and behavioural aspects contribute to HSDD, with hypersexualtiy primary focus on assessment tools; the use of hormonal assays and validated behavioural questionnaires Irrespective of their use, however, these methods have not completely helped in resolving the puzzle and yielding satisfactory elaboration for the development and cause of FSD conditions, and specifically HSDD.

    The next section discusses how ageing factors, such as menopause, are associated with HSDD. Second, the correlation between hormonal profile and HSDD will be detailed, taking into account medical factors that can result in a hormonal imbalance.

    Third, the psychological and psychosocial factors and their effect on HSDD are also outlined. Fourth, the current treatment plans for HSDD are discussed before offering concluding remarks on the current review issue. Moreover, this claim has been supported by a survey 17 undertaken on 31, women aged 18 years and above in the United States of America.

    The study found that the higher prevalence of HSDD was in women above the age of 45 years, and distress was reported to be a major concern among younger women Although sexuality is hyperzexuality to both young and older women, lack of a satisfying sexual life negatively impacts on the overall quality of life The trend is particularly reflected among female groups that experience an unexpected rapid decline in hormone levels as hypersfxuality result of chemical menopause or hypersexkality post-surgical events.

    Figure 1 shows hormone production as hypersezuality function of age, both before and after menopause As evident, between the age of 20 and 40 hypersexuality, there is an increase in the production of sex hormones, before a gradual decline is experienced during menopause and post-menopause years of 45 years and above. On the contrary, other scholars argue that based on longitudinal findings, relationship issues and other non-biologic factors can strongly impact on the overall sexual experience of women other than menopausal changes alone Nonetheless, anxiety, depression, and other relationship changes including conflict in the family, the condition of the relationship, sexual function, and health of a partner can contribute to substantial FSD The common assumption is that menopause contributes to reduced sexual desire as a result of low production of hormones from the ovaries, resulting in loss of oestrogen and reduction in testosterone.

    The next subsections elaborate on the relationship between low testosterone and oestrogen levels on HSDD. Scholars have reported that hypersexuality production of testosterone plays a central role in HSDD. One of the key reasons in support of this claim is that testosterone initiates sexual activities and proliferates sexual desire and behaviour. In addition, testosterone menopause essential in menkpause clitoral and vaginal physiology to facilitate genital lubrication, sensation, and engorgement Therefore, a menopause of testosterone has been reported to contribute to low libido and to reduced sexual pleasure and receptivity Also, low levels of testosterone have been correlated with lack of sexual motivation, fatigue, distress, and overall reduce the sense of well-being Figure 2 shows that there is a significant decline in the production of testosterone four years before menopause, during menopause, and two years into menopause.

    It is not mennopause for women in their pre-menopausal years with functional ovulatory cycles to report HSDD. Hence, there seems to be a close relationship between the production of testosterone and reduced sexual desire, with more effects felt among older women in their post-menopause years and women who have undergone oophorectomy compared with younger ladies and those in their premenopausal years Figure 3 further shows that with increasing age, the levels of testosterone reduce and by the time a woman reaches menopause, the levels of testosterone are almost a quarter of what they were in their early 20s.

    According to Simon et al. Besides low testosterone levels, low sex drive among women can also be affected by reduced levels of oestrogen during postmenopausal years. Low levels of oestrogen results in vulvovaginal dryness and atrophy in addition to initiating changes of genital function through reduced sensory perception and decreased clitoral blood flow As such, it becomes apparent that lack of oestrogen is associated with vaginal discomfort due to dryness and genital insensitivity, making it difficult for an individual to actively respond to sexual expression and cues, considering a reduced impact on desire Researchers have recommended hypersexuality use of oestrogen therapies to treat dyspareunia and vaginal dryness resulting from vulvovaginal atrophy However, oestrogen-based therapies have been questioned as to whether they contribute to the effect after precise use menopauee managing low sexual desire, in the event that low sexual events results from issues such as loss of genital pleasure, sensation, or as a consequence of pain Figure 4 shows the variation in oestrogen production during years of fertility, perimenopause, menopause, and post-menopause.

    As evident from Figure menopausethere is a high variation in oestrogen production during hyperssexuality, and these fluctuations levels contribute to decreased sex libido among women. Besides, both peri- and post-menopausal individuals can experience HSDD due to low levels or deficiency in oestrogen hormone production 30 Laumann et al. In this case, oral oestrogen therapy is often recommended as a replacement to relieve mood changes, hot flashes, and alleviate irregular sleep patterns and improve the quality of life among women hypersexualuty34 However, a study by Laumann et al.

    Hypersexuality of the reasons for this is that oral oestrogen can increase the levels of circulating sex hormone-binding globulin SHBG among menopausal women 3738 hypersexulaity, O elaborate, SHBG has been reported as a protein that can bind testosterone and as a result, lead to lowering of free testosterone levels in the blood Therefore, if the levels of SHBG are high, the level of free testosterone in plasma will be lower.

    In addition, Simon et al. Warnock et al. As such, the ovarian release of oestrogen is suppressed, and as a result, sexual libido is also affected.

    However, the levels of SHBG can be reduced using testosterone replacement therapy, which works by raising the levels of free hypesrexuality and potentially decreasing potential signs and symptoms of HSDD 43 In women, androgens are C19 hyersexuality generated from cholesterol, where the main sources of hypersexuality are from the adrenal glands, peripheral tissues, and the ovaries.

    Figure 5 shows steroidogenesis of androgens in women. Androgens are released from peripheral tissues such as cutaneous, muscle, and adipose tissues. Figure 1 shows that testosterone T represents the final product in the androgen pathway and it results from the conversion of androstenedione A present in plasma.

    As noted from the ageing factors associated with FSD, women can experience the effcets before and after menopause as a result of androgen hormone deficiency Long menopause menopause, and specifically from the second half of the pre-menopausal years when a woman is aged between 30 and 50 years, the development of androgen hormones reduces from the ideal rate observed during puberty and up to the late 20s or early 30s 47 However, from the mids, the normal activities of mneopause hypersexuality reduce, and the process of ovulation becomes irregular.

    Hyperxexuality shown in Figure 6in irregular ovulation cycles, there is less progesterone release, and in cycles where there is no ovulation, there is no release of progesterone As such, as the levels of progesterone start to fall, the hypersxuality cycle becomes shorter and the menopauae of progesterone results in a hormonal imbalance where there is oestrogen dominance.

    The oestrogen dominance is shown in Figure 3in relation to progesterone levels menoapuse are lower than menopause among pre-menopausal women Some of the symptoms linked to increased production of oestrogen at this age include depressive mood and anxiety. As an individual transitions into menopause perimenopausal agethe irregular release of androgen hormones become longer, and women may have reduced sexual desire for prolonged months because they receive irregular menstrual cycles 5051 At the age of 50 years, most women experience a significant reduction in the amounts of androgen, while the values for testosterone and oestrogen reach their minimum levels 5354 Even so, the natural development of menopause can also result in reduced production of androgens 56 In most cases, androgen deficiency is difficult to identify, and most women correlate their reduced sexual desires with lifestyle issues or psychological distress as opposed menopause biologic changes hypersexuuality their bodies Some of the experiences can result in an inexplicable lack of energy, tiredness, low self-motivation, disturbed sleep, a complete lack of sexual desire, and low self-esteem or hypersexualitg general well-being 59 Low levels of androgens menopauxe women and reduced sexual desire can be diagnosed by examining levels of SHBG and testosterone because initial findings reported from women that have undergone surgery are as elaborated below.

    Even if the changes in hormone profile among young women who have undergone hysterectomy and oophorectomy might not entirely affect sexual expression, the increased prevalence of HSDD in young women compared with pre- menopause post-menopausal meopause is a strong indicator for the affect of hormonal levels on sexual desire 6162 The age-associated reduction in androgen hormones parallels the age-linked hypersexaulity in HSDD among women, mainly in those who have reached natural mehopause of menopause with low sexual desire compared with pre-menopause women, further indicating the central role that hormones play in HSDD 64 Menoopause discussed earlier, low levels of oestrogen are largely associated with dyspareunia and vulvovaginal mucosa changes, a move that can contribute to reduced sexual desire among affected women 46 In past studies, women who have undergone oophorectomy have shown to have associated low levels of sexual hyperseuxality and increased distress or poor overall well-being.

    One study found mehopause levels of androgen hormones in healthy hypersexuality women who reported having low sexual desire compared with women without a similar problem The marked decline in low levels of testosterone after surgery has been linked to low sexual ni 6768because most studies have focused on safety, efficacy, and testosterone-route menipause to treat reduced sexual desire. In addition to surgical procedures, a number of medical factors can also affect hormonal levels in women and contribute towards HSDD as menopause in the next section.

    A number of studies have also found a positive relationship between hypersexuality and medical factors. Some researchers reported that some treatments and medical conditions could negatively affect sexual desire among women. Table 1 summarises some diseases that have possible negative impacts on sexual libido.

    Medical interventions and diseases can change the physiology of sexual response both peripherally and centrally 71 Moreover, the presence of sexual disorders, including loss menopauze sensitivity and pain, can hypersexualify negative responses that can make such women lose interest in sexual expression Besides the chronic conditions that contribute to HSDD, Table 2 lists some common medicines reported to cause reduced sexual urge among hypersexuality.

    For example, drugs that give healing benefits for diseases may negatively impact on sexual response among women In most gynaecologic conditions, oral contraceptives are often menopause together in pregnancy prevention. For years, menopause combination and type of progestin kenopause oestrogen have closely been reported in dealing with benign gynaecologic diseases and pregnancy prevention 78 Furthermore, there is increased connection between the oral contraceptive prescription in some women i vulvar vestibular pain.

    In patients with depression, serotonin-norepinephrine reuptake inhibitors SNRI and selective serotonin reuptake inhibitors SSRI medications are commonly prescribed antidepressants, although they commonly result in adverse events, including arousal difficulties, absent orgasm, delayed orgasm, and decreased desire.