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Background: The neurobiology of sexual response is driven in part by dopamine and serotonin-the former modulating excitatory pathways and the latter regulating inhibitory pathways. Neurobiological underpinnings of hypoactive sexual desire disorder HSDD are seemingly related to overactive serotonin activity that in underactive dopamine activity. As such, pharmacologic agents that decrease serotonin, increase dopamine, or some combination thereof, have therapeutic potential for HSDD.

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Aim: To review the role of serotonin in female sexual function and the effects of pharmacologic interventions that target the serotonin system in the treatment of HSDD. Methods: Searches of the Medline database for articles on serotonin and female sexual function. Outcomes: Relevant articles from the peer-reviewed literature were included. : Female sexual response is regulated not only by the sex hormones but also by several neurotransmitters. It is postulated that dopamine, norepinephrine, oxytocin, and melanocortins serve as key neuromodulators for the excitatory pathways, whereas serotonin, opioids, and endocannabinoids serve as key neuromodulators for the inhibitory pathways.

Serotonin appears to be a key inhibitory modulator of sexual desire, because it decreases the ability of excitatory systems to be activated by sexual cues. Centrally acting drugs that modulate the excitatory and inhibitory pathways involved in sexual desire eg, bremelanotide, bupropion, buspirone, flibanserin have been investigated as treatment options for HSDD.

However, only flibanserin, a multifunctional serotonin agonist and antagonist 5-hydroxytryptamine [5-HT] 1A receptor agonist and 5-HT 2A receptor antagonistis currently approved for the treatment of HSDD. Clinical implications: The central serotonin system is 1 biochemical target for medications intended to treat HSDD. Strengths and limitations: This narrative review integrates findings from preclinical studies and clinical trials to elucidate neurobiological underpinnings of HSDD but is limited to 1 neurotransmitter system serotonin. The unique pharmacologic profile of flibanserin tones down inhibitory serotonergic function and restores dopaminergic and noradrenergic function.

Croft HA. J Sex Med ; Published by Elsevier Inc. All rights reserved. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. Search: Search. Advanced Clipboard. Display options Display options. Create file Cancel. citation Subject: 1 selected item: - PubMed.

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Abstract Background: The neurobiology of sexual response is driven in part by dopamine and serotonin-the former modulating excitatory pathways and the latter regulating inhibitory pathways. Kingsberg SA, et al. CNS Drugs. PMID: Review. Simon JA, et al.

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Sex Med Rev. Epub Jun Flibanserin for female sexual dysfunction. Reviriego C. Drugs Today Barc. PMID: Flibanserin for the treatment of hypoactive sexual desire disorder in premenopausal women.

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Dhanuka I, Simon JA. Dhanuka I, et al. Expert Opin Pharmacother. Epub Sep Multifunctional pharmacology of flibanserin: possible mechanism of therapeutic action in hypoactive sexual desire disorder. Stahl SM, et al. J Sex Med. See all similar articles. Ahmed R, Abdallah I. Ahmed R, et al. Neuroanatomy and function of human sexual behavior: A neglected or unknown issue? Brain Behav. Millheiser L, et al.

Sex Med. Publication types Review Actions. Research Support, Non-U. Gov't Actions. MeSH terms Animals Actions. Female Actions. Humans Actions.

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Understanding the Role of Serotonin in Female Hypoactive Sexual Desire Disorder and Treatment Options