The influence of testosterone combined with a PDE5-inhibitor on cognitive, affective, and physiological sexual functioning in women suffering from sexual dysfunction.
BACKGROUND
Women with female sexual dysfunction have a reduced sensitivity to sexual stimuli. Activation of central mechanisms may open a window for phosphodiesterase type 5 inhibitors (PDE5) to be effective; as a consequence, the combination of testosterone and a PDE5 inhibitor will restore sexual function.


OBJECTIVE
To demonstrate that the combination of testosterone and vardenafil will increase the sensitivity for sexual stimuli and will improve the desire and arousal components of the sexual response. Methods. In a double-blind randomly assigned placebo-controlled crossover design, 28 women with desire and/or arousal disorder underwent four different drug treatments on four separate experimental days. A masked version of the emotional Stroop task with sexual and nonsexual words was used to measure sensitivity for sexual content. Neutral and erotic film fragments were used to determine genital-physiological and subjective reactions.


METHODS
A masked version of the emotional Stroop task, vaginal pulse amplitude. For subjective measurement, responses were collected continuously with a lever and two self-report measures were used.


RESULTS
In two subgroups, which were differentiated on the basis of their initial preconscious attentional bias for sexual cues, a different sexual response profile was found. In an initially low-attention group, preconscious attentional bias for sexual cues increased under the testosterone condition. In these women, the combination of testosterone and vardenafil caused an improvement in genital response and subjective indices of sexual functioning. In the group that had initially a high attention for sexual cues, preconscious attentional bias for sexual cues decreased under the condition of testosterone. In these women, the combination of testosterone and vardenafil had no effect on any of the indices of their sexual functioning.


CONCLUSIONS
In women suffering from low sexual desire-associated with low attention for sexual cues-the combination of testosterone and vardenafil may be a promising new treatment.
van der Made
Flip
F
Department of Gynecology and Obstetrics, Flevoziekenhuis, Almere, The Netherlands.
Bloemers
Jos
J
Yassem
Wadi E
WE
Kleiverda
Gunilla
G
Everaerd
Walter
W
van Ham
Diana
D
Olivier
Berend
B
Koppeschaar
Hans
H
Tuiten
Adriaan
A
D000328:Adult; D000339:Affect / Q000187:drug effects*; D001288:Attention; D003071:Cognition / Q000187:drug effects*; D018592:Cross-Over Studies; D003463:Cues; D004311:Double-Blind Method; D004882:Erotica; D005260:Female; D005836:Genitalia, Female / Q000187:drug effects; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology* / Q000627:therapeutic use*; D009040:Motion Pictures; D058986:Phosphodiesterase 5 Inhibitors; D010726:Phosphodiesterase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use*; D010879:Piperazines / Q000494:pharmacology* / Q000627:therapeutic use*; D012725:Sexual Behavior / Q000187:drug effects*; D012735:Sexual Dysfunction, Physiological / Q000188:drug therapy*; D013450:Sulfones / Q000494:pharmacology / Q000627:therapeutic use; D013739:Testosterone / Q000494:pharmacology* / Q000627:therapeutic use*; D014227:Triazines / Q000494:pharmacology / Q000627:therapeutic use; D000069058:Vardenafil Dihydrochloride
D007093:Imidazoles; D058986:Phosphodiesterase 5 Inhibitors; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D013450:Sulfones; D014227:Triazines; D013739:Testosterone; D000069058:Vardenafil Dihydrochloride