Female Sexual Dysfunction – FSD – Possible Emergent Treatments

Testosterone alone

Presently, it is advocated that testosterone treatment must be administered with concurrent oestrogen (progestogens included in those with intact uterus). A latest randomised controlled trial conducted employing transdermal testosterone alone for post-menopausal women having less libido revealed that the use of 300microtestosterone patch caused a major surge in sexual function and lowered anguish.

The major side effect was undesirable hair growth. There were major apprehensions with the surfacing of three breast cancer cases cited in the active arms and none observed in the control set, however this outcome might be due to chance. There is still shortage of long-standing safety information.

PDE5IS or Phoshodiestesterase Inhibitors

During the course of a twelve week long trial, Sildenafil has been proven to enhance pleasure and lubrication. However, a larger multicentre trial has shown no alteration in arousal when evaluated against placebo, but there were major side-effects like headaches, flushing, rhinitis, ocular hindrance and dyspepsia. The other available PDE5IS are still under the scanner.

Bupropion

Sexual dysfunction could be treated by the beneficial use of the antidepressant, Bupropion. One trial has proven a rise in sexual function, but other trials have exhibited patchy outcomes. Those women with eating disorders have been noted to be at an increased risk of seizure attacks if they take bupropion.

Healthy sexual function is a crucial issue for menopausal women. Topical vaginal oestrogen is usually the preliminary line of treatment for atrophic vaginitis. During vaginal oestrogen therapy the following line of medication is followed.

Cream

17 beta-estradiol that is administered 2 to 4 gms/day for one to two weeks, then one to two grams each day for one to two weeks. For the maintenance phase – one gram per day is advised 1-3 times per week.

Conjugated estrogens are recommended in dosage of 0.5 to 2 grams per day.

Oestriol – Ovestin cream, Organon : One application is advised each day for the initial few weeks that is followed by eventual lowering of dose on the basis of improvement in symptoms till a maintenance dose is attained, e.g., one application two times a week.

Ring

17 beta-estradiol. It has a release rate of 7.5 micrograms per day for three months. The total device contains two milligrams.

Vaginal tablets

17 beta-estradiol. Initially one tablet is advised for two weeks. During the maintenance phase, one tablet is recommended for two times in a week.

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