A significant proportion of women reporting female sexual dysfunction (FSD) suffer from hypoactive sexual desire disorder (HSDD) which is characterized by a loss of sexual desire leading to distress. HSDD is highly prevalent in women of any age, but only in the recent years some research has been conducted to uncover the potential causes and to find therapeutic strategies. A complex interplay of biological, psychological and socio-relational factors is related to womenʼs sexual health during the entire reproductive life span. Menopause is a time of vulnerability to sexual symptoms as a result of sex hormonal changes inducing climacteric syndrome. Vaginal dryness is a common feature significantly affecting genital arousal and, consequently, desire, orgasm and satisfaction. Recently, HSDD has been well described especially in surgical menopause, a clinical condition clearly characterized by the loss of both estrogens and androgens. Therefore, the major focus is on hormonal treatments, in particular the testosterone (T) patch which is able to restore T levels to premenopausal stage with a significant improvement of sexual activity, desire and satisfaction, reducing women’distress both in surgical and natural menopause.

However, there is a medical need to develop novel therapies that can be used even in younger women. A great hope comes from drugs acting on central nervous dopaminergic, serotoninergic and noradrenergic pathways involved in mental drive, arousal and satisfaction.

In any case, hormonal and non hormonal treatments and/or psychosexual strategies should be individualized and tailored on womenʼs history and current needs to counteract the distress associated with HSDD.