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Female sexual dysfunction:Treatments and drugs



Female sexual dysfunction:Treatments and drugs
Women with sexual concerns most often benefit from a combined treatment approach that addresses medical as well as emotional issues. Occasionally, there's a specific medical solution — using vaginal estrogen therapy, for example, or switching from one antidepressant medication to another. More often, behavioral treatments — such as couples therapy and stress management — are needed to address the cause of female sexual dysfunction. And sometimes, a combination approach works best.
Nonmedical treatment for female sexual dysfunction
You can improve your sexual health by enhancing communication with your partner and making healthy lifestyle choices.

Talk and listen. Some couples never talk about sex, but open and honest communication with your partner can make a world of difference in your sexual satisfaction. Even if you're not used to communicating about your likes and dislikes, learning to do so and providing feedback in a nonthreatening manner can set the stage for greater sexual intimacy.
Practice healthy lifestyle habits. Avoid excessive alcohol. Drinking too much will blunt your sexual responsiveness. Also, stop smoking and start exercising. Cigarette smoking restricts blood flow throughout your body, and less blood reaching your sexual organs means decreased sexual arousal and orgasmic response. Regular aerobic exercise can increase your stamina, improve your body image and elevate your mood, helping you feel more romantic, more often. Finally, don't forget to make time for leisure and relaxation. Learning to relax amid the stresses of your daily life can enhance your ability to focus on the sexual experience and attain better arousal and orgasm.
Seek counseling. Talk with a counselor or therapist specializing in sexual and relationship problems. Therapy often includes education about how to optimize your body's sexual response, ways to enhance intimacy with your partner, and recommendations for reading materials or couples exercises. With a therapist's help, you may gain a better understanding of your sexual identity, beliefs and attitudes; relationship factors including intimacy and attachment; communication and coping styles; and your overall emotional health.
Medical treatment for female sexual dysfunction
Effectively treating sexual dysfunction often requires addressing an underlying medical condition or hormonal change that's affecting your sexuality.

Treating female sexual dysfunction tied to an underlying medical condition might include:

Adjusting or changing medications that have sexual side effects
Treating thyroid problems or other hormonal conditions
Optimizing treatment for depression or anxiety
Trying strategies recommended by your doctor to help with pelvic pain or other pain problems
Treating female sexual dysfunction linked to a hormonal cause might include:

Estrogen therapy. Localized estrogen therapy — in the form of a vaginal ring, cream or tablet — can improve sexual function in a number of ways, including improving vaginal tone and elasticity, increasing vaginal blood flow, enhancing lubrication, and having a positive effect on brain function and mood factors that impact sexual response.
Androgen therapy. Androgens include male hormones, such as testosterone. Testosterone is important for sexual function in women as well as men, although testosterone occurs in much lower amounts in a woman. Androgen therapy for sexual dysfunction is controversial. Some studies show a benefit for women who have low testosterone levels and develop sexual dysfunction; other studies show little or no benefit.

Testosterone may be given as a cream that you apply to your skin. Sometimes, testosterone is given as a pill in combination with estrogen. Side effects, such as acne, excess body hair (hirsutism), enlargement of the clitoris, and mood or personality changes, are possible. Because long-term effects of testosterone therapy in women aren't known, you should be closely monitored by your doctor.

Hormonal therapies won't resolve sexual problems that have causes unrelated to hormones. Because the issues surrounding female sexual dysfunction are usually complex and multifaceted, even the best medications are unlikely to work if other emotional or social factors remain unresolved.

Other possible medical treatments
More research is needed before these agents might be recommended for treatment of female sexual dysfunction:

Tibolone. Tibolone is a synthetic steroid drug currently used in Europe and Australia for treatment of postmenopausal osteoporosis. In one randomized trial, postmenopausal women taking the drug experienced an improvement in overall sexual function and a reduction in personal distress compared with postmenopausal women taking estrogen, but the effect was small. Due to concerns over increased risk of breast cancer and stroke in women taking tibolone, the drug isn't approved by the Food and Drug Administration (FDA) for use in the U.S.
Phosphodiesterase inhibitors. This group of medications has proven successful in treating erectile dysfunction in men, but the drugs don't work nearly as well in treating female sexual dysfunction. At best, studies looking into the effectiveness of these drugs in women have yielded inconsistent results. One drug, sildenafil (Viagra) may prove beneficial for some women who experience sexual dysfunction as a result of taking selective serotonin reuptake inhibitors, a class of drugs used to treat depression.