Medicinal plants as alternative treatments for female sexual dysfunction: utopian vision or possible treatment in climacteric women?
BACKGROUND
Female sexual dysfunction (FSD) is a complex and multifactorial condition. An increased incidence of FSD is especially associated with the decline of estrogen. Thus, menopause is a critical phase for FSD complaints. In this context, medicinal plants may be a therapeutic option.


OBJECTIVE
To identify and describe the popular and clinical uses of medicinal plants for FSD treatment in climacteric women. We highlighted the majority of the plants commonly involved with the female reproductive system including: Angelica sinensis, Cimicifuga racemosa, Ferula hermonis, Ginkgo biloba, Humulus lupulus, Lepidium meyenii, Tribulus terrestris, Trifolium pratense, and Vitex agnus-castus.


METHODS
This study is a narrative review of studies of plants that are possible alternative treatments for FSD. The species described have clinical and popular uses in different cultures as well as medical indications for female reproductive disturbances, mainly in climacteric women. We have also analyzed the evidence level of clinical studies.


METHODS
The main outcome assessed is the efficacy of plants in improving the symptoms of FSD.


RESULTS
There is little evidence from the literature to recommend the use of medicinal plants when treating FSD. The majority of studies with a strong level of evidence are associated with the treatment of the vasomotor symptoms of menopause. Ferula hermonis, Angelica sinensis, and Gingko biloba may be suggested for arousal disorder studies. Cimicifuga racemosa, Trifolium pratense, and Vitex agnus-castus may be recommended for several FSD. Humulus lupulus and Tribulus terrestris may help with desire disorder studies. Lepidium meyenii should be studied further.


CONCLUSIONS
Studies of these plants indicate that they may be useful as a possible alternative and/or complementary approach for studies aimed at the treatment of FSD. At this time, however, this review cannot recommend a plant that has a strong enough level of evidence for treatment of FSD. Thus, there is a need for clinical (double-blinded and randomized) studies to evaluate the efficacy and safety of several plants that can exert a positive effect on the management of FSD.
Mazaro-Costa
Renata
R
Universidade Federal de São Paulo-Departamento de Psicobiologia, R. Napoleão de Barros, São Paulo, SP, Brazil.
Andersen
Monica L
ML
Hachul
Helena
H
Tufik
Sergio
S
D000368:Aged; D004414:Dyspareunia / Q000188:drug therapy*; D005260:Female; D020441:Ginkgo biloba; D012739:Gonadal Steroid Hormones / Q000627:therapeutic use; D006801:Humans; D008593:Menopause / Q000523:psychology*; D008875:Middle Aged; D048789:Phytoestrogens / Q000627:therapeutic use; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*; D010946:Plants, Medicinal; D018456:Reproductive Medicine; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D014601:Utopias; D016387:Women's Health
D012739:Gonadal Steroid Hormones; D048789:Phytoestrogens; D010936:Plant Extracts; D020845:Selective Estrogen Receptor Modulators