Emerging therapies for female sexual dysfunction.
Epidemiological studies in the US, the UK and Sweden indicate that approximately 40% of women aged 18 - 59 have significant complaints about their sexual lives. The majority of complaints concern low sexual desire. Other common problems include difficulty reaching orgasm, insufficient lubrication and painful coitus. A vacuum erection device which increases blood flow to the clitoris has been approved by the US Food and Drug Administration. There are no pharmacological agents with approval for the treatment of female sexual dysfunction. Phosphodiesterase inhibitors and other drugs which cause genital vasocongestion in women appear to have minimal clinical efficacy. Although many of these agents increase the vasocongestive response to sexual stimulation, there is minimal correlation between subjective and objective measures of sexual arousal in women. Trials with androgens have clearly and convincingly demonstrated that supraphysiological doses of testosterone increase libido in postmenopausal women. The long-term safety of such doses is unclear. To date, no studies have shown lower doses of androgens to be beneficial. There have been minimal studies of drugs targeting the central nervous system to date. Bupropion may have a beneficial effect on orgasm attainment in women with hypoactive sexual desire disorder.
Segraves
Robert Taylor
RT
Department of Psychiatry, MetroHealth Medical Center, 2500 Metrohealth Drive, Cleveland, Ohio 44109-1998, USA. Rsegraves@metrohealth.org
D000728:Androgens / Q000627:therapeutic use; D002491:Central Nervous System Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004414:Dyspareunia / Q000188:drug therapy; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D006801:Humans; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D020018:Sexual Dysfunctions, Psychological / Q000188:drug therapy*; D014665:Vasodilator Agents / Q000627:therapeutic use
D000728:Androgens; D002491:Central Nervous System Agents; D004967:Estrogens; D010726:Phosphodiesterase Inhibitors; D014665:Vasodilator Agents