In this month's Letters to the Editor, one reader responds to an article on testosterone therapy in women and another looks to address urology's work force shortage.
To the Editor:
I read your article on UrologyTimes.com, “Testosterone therapy in women: Is there a benefit?” that discusses a meta-analysis finding flibanserin (Addyi) to have similar results as placebo, and suggests “conservative options” for treatment of hypoactive sexual desire disorder (HSDD), such as couples counseling and pelvic floor physical therapy.
Contrary to the findings of the meta-analysis that Dr. Beverly Reed references, according to “Efficacy and Safety of Flibanserin in Women with Hypoactive Sexual Desire Disorder: A Systematic Review and Meta-Analysis” by Gao et al, women receiving flibanserin reported that their condition had improved and that they received a meaningful benefit, compared with those who received placebo (J Sex Med 2015; 12:2095-104). The authors of this analysis also concluded that flibanserin appears to provide a good balance between efficacy and side effects.
In the article, Dr. Reed also minimizes the legitimacy of HSDD as a true medical condition, suggesting that it can be remedied by counseling and pelvic floor therapy. In reality, HSDD was described by Helen Singer Kaplan, MD, PhD, in 1977, and codified by the American Psychiatric Association in 2000. Furthermore, hundreds of peer-reviewed HSDD scientific articles have been published.
Women struggling with HSDD are often told that their suffering is not real or that it is “all in their heads,” and are offered solutions that are not legitimate. We need to give a voice to these women and validate that HSDD is a true medical condition, and that treatment options should be made available.
James A. Simon, MD, CCD, NCMP
George Washington University
To the Editor:
Regarding the article, “Work force shortage projections climb” (May 2016, page 1), it would seem like this study should factor in the growth of urogynecologists in practice. If one were to factor this in, the short fall projections might not be so bad. Granted, urogynecologists and urologists don’t do exactly the same thing but there is considerable overlap in services provided (for women at least).
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