A Practical Guide To Female Sexual Dysfunction

[Michael Scally MD]

[OA] A Practical Guide To Female Sexual Dysfunction

Introduction: Female sexual dysfunction (FSD) is characterized as distress related to sexual pain, sexual arousal, sexual desire, and/or orgasmic dysfunction. Despite prevalence rates similar to male sexual dysfunction, women with sexual complaints have been long under-evaluated, treated, and studied. Over the last decade there have been advances in the medical evaluation and management of FSD, however, there remains a paucity of clinical resources available for women in Canada with sexual dysfunction.

Methods: The state of knowledge in the evaluation and treatment of FSD was reviewed. Recommendations are given for the practical evaluation and treatment of women with sexual symptoms that can be applied widely in Canada.

Results: Approaches to the management and treatment of FSD are discussed with a focus on the practical application of diagnostic and therapeutic tools in the management of sexual pain, low desire, low arousal, and orgasmic dysfunction.

Conclusions: There are evidence-based diagnostic and therapeutic approaches to FSD that can be broadly applied by Canadian physicians to improve access to female sexual medicine in Canada.

Krakowsky Y, Grober ED. A Practical Guide To Female Sexual Dysfunction: An Evidence-Based Review For Physicians In Canada. Canadian Urological Association Journal. 2018;12(6). https://cuaj.ca/index.php/journal/article/view/4907

 

[Michael Scally MD]

A sex-specific dose-response curve for testosterone: could excessive testosterone limit sexual interaction in women?

Testosterone treatment increases sexual desire and well-being in women with hypoactive sexual desire disorder; however, many studies have shown only modest benefits limited to moderate doses.

Unlike men, available data indicate women show a bell-shaped dose-response curve for testosterone, wherein a threshold dosage of testosterone leads to desirable sexual function effects, but exceeding this threshold results in a lack of further positive sexual effects or may have a negative impact.

Emotional and physical side-effects of excess testosterone, including aggression and virilization, may counteract the modest benefits on sexual interaction, providing a possible explanation for a threshold dose of testosterone in women.

In this commentary, we will review and critically analyze data supporting a curvilinear dose-response relationship between testosterone treatment and sexual activity in women with low libido, and also explore possible explanations for this observed relationship.

Understanding optimal dosing of testosterone unique to women may bring us one step closer to overcoming regulatory barriers in treating female sexual dysfunction.

Krapf JM, Simon JA. A sex-specific dose-response curve for testosterone: could excessive testosterone limit sexual interaction in women? Menopause (New York, NY) 2017;24:462-70. A sex-specific dose-response curve for testosterone: could ... : Menopause