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Antisocial personality disorder

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Antisocial personality disorder is a type of chronic mental condition in which a person's ways of thinking, perceiving situations and relating to others are dysfunctional — and destructive. People with antisocial personality disorder typically have no regard for right and wrong and often disregard the rights, wishes and feelings of others.

Those with antisocial personality disorder tend to antagonize, manipulate or treat others either harshly or with callous indifference. They may often violate the law, landing in frequent trouble, yet they show no guilt or remorse. They may lie, behave violently or impulsively, and have problems with drug and alcohol use. These characteristics typically make people with antisocial personality disorder unable to fulfill responsibilities related to family, work or school.

References Antisocial personality disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed March 1, 2013.Paris J, et al. Antisocial and borderline personality disorders revisited. Comprehensive Psychiatry. In press. Accessed March 1, 2013.Black DW. Antisocial personality disorder: Epidemiology, clinical manifestations, course and diagnosis. http://www.uptodate.com/home. Accessed March 1, 2013.Black DW. Treatment of antisocial personality disorder. http://www.uptodate.com/home. Accessed March 1, 2013.Shi Z, et al. Childhood maltreatment and prospectively observed quality of early care as predictors of antisocial personality disorder features. Infant Mental Health Journal. 2012;33:55.Kendall T, et al. Borderline and antisocial personality disorders: Summary of NICE guidance. British Medical Journal. 2009;338:293.Alarcon RD (expert opinion). Mayo Clinic, Rochester, Minn. March 21, 1013.Palmer BA (expert opinion). Mayo Clinic, Rochester, Minn. April 1, 2013.

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Testosterone therapy in women: Does it boost sex drive?

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Research shows that the hormone testosterone does impact sex drive — as well as remedy other sexual problems — in certain women with sexual dysfunction. But the long-term safety of testosterone therapy for women is unknown. For this reason, some doctors are hesitant to recommend it. Testosterone therapy usually is prescribed only for women who have sufficient estrogen levels.

Testosterone therapy might be appropriate if:

You have reduced sex drive, depression and fatigue after surgically induced menopause, and estrogen therapy hasn't relieved your symptomsYou are postmenopausal, taking estrogen therapy and have a decreased sex drive with no other identifiable causes

Long-term safety data on testosterone therapy for postmenopausal women who have a history of breast or uterine cancer or those who have cardiovascular or liver disease is lacking and being studied.

Testosterone therapy comes in many forms, such as creams, gels, patches or pills. The method of administration and dose relate to safety risks, so it's important to discuss pros and cons with your doctor.

Testosterone preparations are not approved by the Food and Drug Administration for use in women. So if testosterone is prescribed, it's for off-label use.

Although testosterone contributes to healthy sexual function in women, many other factors also play a role in postmenopausal sexual dysfunction. These factors include decreased estrogen levels, vaginal dryness, medication side effects, chronic health conditions, loss of a spouse or partner, lack of emotional intimacy, conflict, stress, or mood concerns.

Next question References Davis SR, et al. Current perspectives on testosterone therapy in women. Menopausal Medicine. 2012;20:S1.Davis SR, et al. Efficacy and safety of testosterone in the management of hypoactive sexual desire disorder in postmenpausal women. Journal of Sexual Medicine. 2012;9:1134.Shifren JL. Sexual dysfunction in women: Management. http://www.uptodate.com/home. Accessed March 18, 2013.Hobbs K, et al. Clinical inquiries: Which treatments help women with reduced libido? The Journal of Family Practice. 2013;62:102.Yasui T, et al. Androgen in postmenopausal women. The Journal of Medical Investigation. 2012;59:12.American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Obstetrics. ACOG Practice Bulletin No. 119: Female Sexual Dysfunction. Obstetrics and Gynecology. 2011;117:996.Glaser R, et al. Testosterone therapy in women: Myths and misconceptions. Maturitas. 2013;74:230.Woodis CB, et al. Testosterone supplementation for hypoactive sexual desire disorder in women. Pharmacotherapy. 2012;32:38.Gallenberg MM (expert opinion). Mayo Clinic, Rochester, Minn. March 22, 2013.Thielen JM (expert opinion). Mayo Clinic, Rochester, Minn. April 6, 2013.

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