An excellent overview post appeared on the KevinMD.com blog, titled Female sexual dysfunction treatment options, written by Jill of All Trades, MD: http://www.kevinmd.com/blog/2010/05/female-sexual-dysfunction-treatment-options.html .
It is worthwhile to capture the introductory paragraphs of Jill’s post here:
Female sexual dysfunction has been reported in up to 40% of women, and described as causing actual distress in approximately 12% of women.
Michelangelo, The Last Judgment, 2 cropped
Therefore, it is an important topic to familiarize with and screen for as a primary care physician, as many patients may not report these symptoms unless they are elicited during the history taking process of the patient encounter. Female sexual dysfunction is often multifactorial and complex; it is affected by such factors as depression and anxiety disorders, life stressors, interpersonal conflict between the couple, medication side effects, age, religious concerns, personal health, privacy issues, personal body image, substance and alcohol abuse, and hormonal influences.
In order to understand the necessary treatment options, it is important to understand the normal female sexual cycle. There are four phases:
1. Libido: the desire for sexual intimacy, through images or thoughts.
2. Arousal: the increase in heart rate, blood pressure, and respiratory rate, along with increased genital blood flow.
3. Orgasm: the peak of sexual pleasure, with rhythmic contractions of the pelvic muscles.
4. Resolution: the return to baseline with pelvic muscle relaxation.
Michelangelo The Last Judgment
The author then very nicely and concisely reviews the treatment options.
I posted the following comment, which at this writing was “awaiting moderation”. –
Thank you for an excellent overview.
I envisage that our Ovulona™ personal vaginal monitor (https://biozhena.wordpress.com/2007/12/11/the-ovulona™ ) will do two useful things for peri-menopausal women and their physicians (https://biozhena.wordpress.com/2008/10/06/ovulona-is-not-another-ovulation-kit ):
#1. Detect effect of any treatment on vaginal tissues and thus allow for personalization of therapy, titration of medications); and
#2. Allow vaginal delivery of therapeutic compounds.
The Ovulona should become a friendly companion tool for all women, to be routinely used from adolescence to peri-menopause (not only for reproductive management, its primary – or certainly initial – purpose).
Ref.: https://biozhena.wordpress.com/2007/12/18/menopause-hrt-and-biozhena/
Regards,
@bioZhena
Michelangelo, The Last Judgment, 2
To this, for the purpose of bioZhena’s Weblog, I would add a reminder about the significance of the problem of (tissue) atrophy, which the reader will find in The Alphabet of bioZhena (under A in the article titled Atrophy) at https://biozhena.files.wordpress.com/2007/11/aaee-the-alphabet-of-biozhena.pdf .
Atrophy means a wasting away, deterioration, or diminution, any weakening or degeneration (especially through lack of use). Read the article, you’ll see about genitourinary atrophy that leads to a variety of symptoms (in both sexes), affecting the quality of life.
And more, including about “estrogen therapy, which is invariably successful in reversing the atrophic problems. Relief from these problems often results in significant improvements in general well-being.”
In my comment above, #1 (detect the effect of treatment on vaginal tissues), the need for personalization of estrogen therapy is reflected, which requires the end-organ effect measuring tool that we provide. See also under E for End-organ effect in the Alphabet of bioZhena at https://biozhena.files.wordpress.com/2007/11/aaee-the-alphabet-of-biozhena.pdf .
bioZhena's Weblog 