Pharmacotherapy for women's sexual dysfunction

Background: Women's sexual function is known to be strongly influenced by mental health and relationship factors. Biological factors interrupting sexual function that might potentially be remedied by pharmacological agents are less clear. Objectives: To examine the role of medications for women's sexual dysfunction. Methods: Searches were done using Medline, Embase, Lilacs and Pubmed databases. Conclusions: Although drugs designed to boost initial sexual desire have been trialed, amelioration of reduced sexual arousability may be a more appropriate target. There is limited evidence of pharmacological benefit to arousability so far. Local oestrogen therapy benefits reduced genital vasocongestion from vulvar vaginal atrophy. Drugs acting to enhance the actions of nitric oxide or vasoactive intestinal polypeptide can only benefit reduced genital congestion: most women complaining of low arousal have normal genital vasocongestion in response to sexual stimulation. In the context of autonomic neuropathies, phosphodiesterase inhibitors may be indicated. Early results of sexual benefit from local administration of dihydroepiandrosterone allowing intracellular production of oestrogen and testosterone in genital tissues post menopause seem promising.