What is Female Sexual Dysfunction?

Female sexual dysfunction or FSD, is a widespread and progressive health concern affecting women that increases with age. Today, FSD afflicts more than 40% of women with minimal available treatment options. What is even more alarming, is that only a fraction of women with FSD actually seek medical attention.

Symptoms which are generally associated with FSD include but are not limited to:

• Reduced vaginal lubrication.
• Pain and soreness during intercourse.
• Diminished sensitivity, inhibited sexual arousal and overall problems in attaining orgasm.

In contrast to the tremendous amount of research and available treatment for male sexual dysfunction, considerably less medical research and development is being done in furthering treatment options for female sexual dysfunction. Even animal research study models have been used to better understand the health condition. Yet today, the predominant treatment for FSD has been psychological therapy.

Moreover, several serious cardiovascular diseases have been associated with women suffering from FSD. The heart conditions associated with FSD include:

• Atherosclerosis
• Hypertension
• Peripheral Arterial Disease

Normal sexual function is a vital part of life, not only for procreation but also as it relates to an individual’s quality of life. Women who suffer from sexual dysfunction, are impacted in their quality of life, psychological health and procreation advancement.

Female Sexual Dysfunction Medically Defined

Health sexual function involves a complicated neurovascular activity, which is regulated by hormonal and psychological factors. Similar to other organized physiological responses, several systems are at play for this function. One example is that in order for a woman to achieve a gratifying sexual experience, clitoral and vaginal function is dependent on adequate blood supply, pressure and volume during periods of arousal, orgasm as wells as post-orgasm.

The World Health Organization has defined female sexual dysfunction as ‘the variety of ways that a woman is unable to take part in a sexual relationship as she desires.’ As you can tell from the definition of female sexual dysfunction, it is far more complex than male sexual dysfunction. The complexity of FSD is related to the difficulty in categorizing a woman’s view about sex in comparison to men. FSD is a multi-dimensional disorder, which involves anatomical, physiological, psychological and social-interpersonal components.

What Causes Female Sexual Dysfunction

Generally, sexual problems in women occur as a result of hormonal changes. Hormonal changes are common in women after giving birth and breast-feeding, as well as throughout menopause. In addition to changes in hormones, common illnesses which include cardiovascular disease, cancer and diabetes, may also further female sexual dysfunction.

There is also a correlation between sexual dysfunction and issues which include:

• Physical Factors. Medical issues which can advance sexual dysfunction include, bladder difficulties, cancer, heart disease, kidney failure and even multiple sclerosis. There are also certain drugs which can lower women’s sexual desire and inhibit the ability to have orgasms. These prescription drugs include, antidepressants, antihistamines, chemotherapy drugs and medications for controlling blood pressure.
• Hormonal Factors. After menopause, women have significantly lower levels of estrogen which can result in variations of genital tissue as well as sexual sensitivity levels. Due to lower estrogen levels, blood flow to the pelvic region is reduced, which causes less feeling in the genitals and makes it more difficult to reach orgasm. Furthermore, the lining of the vagina loses elasticity and becomes thinner, especially if sexual activity diminishes. This leads to a condition call dyspareunia (painful intercourse).
• Psychological and Social Factors. Depression and anxiety, when not treated, can trigger and even worsen sexual dysfunction. Long-term unresolved issues with a woman’s partner about sex or other facets of the relationship can also contribute to sexual dysfunction. Other psycho-social factors include religious and cultural beliefs as well as poor body image.

There are also some additional factors which are associated with female sexual dysfunction including:

• Cardiovascular and blood vessel disease.
• Liver conditions and/or disease.
• Urinary tract infections.
• Spinal cord injuries and neurological disorders.
• Gynecological issues, which includes Vulvovaginal Atrophy and Lichen Sclerosus.
• Alcohol, smoking as well as drug abuse issues.
• History and/or trauma related to sexual abuse.
• Fatigue, stress and lifestyle factors.

How is Female Sexual Dysfunction Diagnosed?

Female sexual dysfunction is generally diagnosed by review of symptoms and family history as well as a physical exam. Additional lab tests may be ordered to eliminate other potential issues that may be contributing to sexual dysfunction. The physician may also do a pelvic exam to check the cervix for cancer or precancerous cells.

Available Treatment

Hormone Replacement Therapy

Hormones are a critical component of healthy sexual function in women. Decreased levels of the hormone estrogen in women normally occurs as a result of aging. Lower estrogen levels are associated with diminished genital sensation as well as inadequate vaginal lubrication. Additionally, low levels of the hormone testosterone can add to sexual arousal decrease, genital sensitivity. One form of treatment for female sexual dysfunction is hormone replacement therapy, which is prescribed in order to bring hormones to the appropriate healthy levels.

Another hormone modulator option is Tibolone, which is a synthetic steroid generally used to treat menopausal symptoms. It has been reported that Tibolone treatment in women increased overall sexual function and frequency as well as a reduction of personal distress.

PDE5 Inhibitors and PT141 for Female Sexual Dysfunction

PDE5 inhibitors (sildenafil, tadalafil and vardenafil) have already been well established for the treatment of erectile dysfunction by increasing greater blood delivery to the genitals in men. Recent clinical studies on women, have revealed that sildenafil substantially increased clitoral blood flow, heightened sexual arousal and improved ability to achieve orgasm.

PT141 Bremelanotide is the newest drug for female sexual dysfunction and has been shown to increase sexual arousal by stimulating the hypothalamus to release dopamine.