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Treatment Options for female sexual dysfunction

Treatment Options for female sexual dysfunction

Female Sexual Dysfunction remains an evolving area lending itself to various levels of diagnostic and treatment approaches. The shift made by the recent DSM V classification translated into a need for more sophisticated and integrated provision of care to women seeking help. However, the mainstay of management of FSD continues to rest on non-hormonal, hormonal, and psycho-cognitive algorithms. Essential to that is a proper history taking and patient interview capturing all aspects of a woman’s life, physical, and psychological status.

Regarding hormonal treatment, estrogen is a fundamental sexual hormone with various negative effects on woman’s sexuality when it is deficient. Evidence indicates a significant sexual role for estrogen in the brain and genitals, both locally and systematically, with acceptable safety margins and close follow up. Evidence from European studies reveals a therapeutic role for testosterone in problems of desire (interest/arousal) although it remains non-FDA approved.

In view of negative effect of common mental disorders and the role of dopamine and serotonin on excitatory/inhibitory balance in female sexuality, a drug with preferential affinity for serotonin 5-HT (1A agonist and 2A antagonist) receptors and dopamine D receptors has been developed for treatment of HSDD (Flibanserin). Research supports a role for monoamine pharmacologic agents in treating sexual dysfunction. New SERMs and ERAA are also coming in. Oral triphenyl ethylene (Ospemifene), FDA approved for dyspareunia, improves vaginal indices. Tissue Selective Estrogen Complex (TSEC), pairing of CE with SERM, Bazedoxefine (BZA), to alleviate hot flushes, and is FDA approved. Intravaginal DHEA ovules have been found to have beneficial effects on all 4 aspects of sexual function: desire, arousal, orgasm, and pain.

There are more data to support new treatment modalities like rejuvenation therapy (CO2 laser), genital surgery, as well as oxytocin, lidocaine, and others. Cognitive and psychotherapy continue to have a structural role in FSD management.

Areas of Interest / Categories: Female Sexual Dysfunction

Female Sexual Dysfunction

Painful Intercourse & Endometriosis: Sexual Impacts on Male Partner

Is There Such a Thing as “Normal” Desire? DSM-5 and Beyond

What is needed from WHO sexual dysfunction guidelines: A perspective from a practitioner in Latin America

Using a mind/body model for the management of Sexual Pain

Dr Anita Elias will present a practical assessment and management tool that helps patients understand the connection between their thoughts, emotions and physical sexual responses. This model considers

The impact of study design on prevalence estimates of Female Sexual Dysfunction

Despite increasing research, the true prevalence of Female Sexual Dysfunction (FSD) remains a contentious issue. Previous research suggests that aspects of study design affect the reported prevalence of FSD. We compare commonly used instruments for assessing FSD. 

Endometriosis and quality of sexual life: what do we know?

This presentation will summarize current knowledge on sexual function and dysfunction in patients with endometriosis, and present an overview of empirical literature on the experience of the disease. This paper is based on review of articles on this subject published in the Medline (PubMed) database, selected according to their scientific relevance.

Male and female sexual dysfunctions: Results of four years of clinical activty

The main purpose of this study is to examine the requests presented by a sample of patients in an institute of clinical sexology in Rome. This study analyses the clinical reports of 380 patients, 184 women and 196 men, ages 17-70 years (mean=34.99; SD=10.767), attending the institute between 2004 and 2008. The sample was divided into groups, males and females who required consultation for themselves and subjects who asked for a couple’s consultation. The valuation methods to classify sexual dysfunctions are referred to DSM-IV-TR. Descriptive statistics were used to analyze data.