Treatment for Female Sexual Dysfunction
There are three primary types of treatment for female sexual dysfunction:
- Education on female anatomy, arousal, and response; where blood flow, hormone levels, and sexual anatomy are normal
- Hormone replacement therapy (including treatment of the underlying disorder)
- Vascular treatment (including treatment of the underlying disorder)
In August 2015, the U.S. Food and Drug Administration (FDA) approved fibanserin (Addyi), the little "pink pill," to treat acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. It is available in the Unites States beginning October 24, 2015.
Fibanserin carries a Boxed Warning highlighting an increased risk for severe low blood pressure (hypotension) and fainting (syncope) in women who drink alcohol, women with liver problems, and women who take moderate or strong CYP3A4 inhibitors (e.g., certain arrhythmics, antibiotics, antifungals, calcium channel blockers, protease inhibitors, etc.). It is taken once daily before bed (to reduce adverse effects).
The approved dosage of fibanserin is 100 mg. In clinical studies, about 10 percent more women taking Addyi reported significant improvements in sexual events and desire and reduced levels of distress over sexual problems than those who took a placebo (inactive, harmless medicine). The drug has not been found to improve sexual performance. Common side effects include dizziness, sleepiness, nausea, fatigue, insomnia, and dry mouth.
Education & FSD
Educating both women and men on how to talk about and respond to a woman's psychological and physical stimulatory needs can only happen if both partners recognize that there is a problem. Behavioral and sex therapists note the need for partners to examine the actual act of having sex, including foreplay, intercourse, and talking about sex. Sex therapists and psychologists may assist in improving communication between partners.
Hormone Replacement Therapy & FSD
Hormone replacement therapy (HRT) is aimed at restoring hormone levels affected by age, surgery, or hormone dysfunction to normal, thus restoring sexual function. Estrogen and testosterone levels are measured and treated by endocrinologists.
Vascular Treatments for FSD
Medical conditions that cause diminished blood flow to the reproductive organs (e.g., diabetes) must be treated to improve sexual function in both women and men. However, some women who are not diagnosed with an underlying medical condition have found that nonprescription topical creams and gels, such as Sensua! (formerly called Viacreme) or Viagel, increase sensitivity and assist in achieving orgasm.
Sensua! is an amino-acid based (L-arginine) solution that contains menthol. L-Arginine is involved in nitric oxide synthesis, which is responsible for vascular and nonvascular smooth muscle relaxation. When applied to the clitoris, Sensua! may increase blood flow by dilating clitoral blood vessels. More research is being done to assess the possible effects and complications of topical creams.
Sildenafil (Viagra), used in men with erectile dysfunction, is currently being tested in women. Some evidence suggests that it may restore libido lost to antidepressant use.
Eros Therapy is an FDA-approved device for the treatment of female sexual dysfunction. This small handheld device is used 3 to 4 times per week to increase blood flow to the clitoris and external genitalia, which improves clitoral and genital sensitivity, lubrication, and the ability to experience orgasm. It may take several weeks of conditioning before experiencing the benefits of this therapy.
Updated by Remedy Health Media with information from the U.S. Food and Drug Administration (FDA)