Search

Introduction: In recent years, multiple hormones have been investigated in relation to female sexual function. Because consumers can easily purchase products claiming to contain these hormones, a clear statement regarding the current state of knowledge is required. Aim: To review the contribution of hormones, other than estrogens and androgens, to female sexual functioning and the evidence that specific endocrinopathies in women are associated with female sexual dysfunction (FSD) and to update the previously published International Society of Sexual Medicine Consensus on this topic. Methods: The literature was searched using several online databases with an emphasis on studies examining the physiologic role of oxytocin, prolactin, and progesterone in female sexual function and any potential therapeutic effect of these hormones. The association between common endocrine disorders, such as polycystic ovary syndrome, pituitary disorders, and obesity, and FSD also was examined. Main Outcome Measures: Quality of data published in the literature and recommendations were based on the Grading of Recommendations Assessment, Development and Education system. Results: There is no evidence to support the use of oxytocin or progesterone for FSD. Treating hyper-prolactinemia might lessen FSD. Polycystic ovary syndrome, obesity, and metabolic syndrome could be associated with FSD, but data are limited. There is a strong association between diabetes mellitus and FSD. Conclusion: Further research is required; in particular, high-quality, large-scale studies of women with common endocrinopathies are needed to determine the impact of these prevalent disorders on female sexual function. [ABSTRACT FROM AUTHOR]

Introduction: Sex steroids are important in female sexual function and dysfunction. Aim: To review the role of estrogens in the physiology and pathophysiology of female sexual functioning and the evidence for efficacy of estrogen therapy for female sexual dysfunction to update the previously published International Society of Sexual Medicine Consensus on this topic. Methods: Panel members reviewed the published literature using online databases for studies pertaining to estrogen in female sexual function and dysfunction. Attention was specifically given to clinical trials that had reported on sexual function outcomes in women treated with estrogen. Main Outcome Measures: Quality of data published in the literature and recommendations were based on the GRADES system. Results: Observational studies that have considered relationship factors and physical or mental health have reported that these factors contribute more to sexual functioning than menopausal status or estrogen levels. Few clinical trials have investigated estrogen therapy with sexual function as a primary outcome. The available data do not support systemic estrogen therapy for the treatment of female sexual dysfunction. Topical vaginal estrogen therapy improves sexual function in postmenopausal women with vulvovaginal atrophy (VVA) and is considered first-line treatment of VVA. Oral ospemifene, a selective estrogen receptor modulator, is effective for the treatment of VVA and might have independent systemic effects on female sexual function. Conclusion: For sexual problems, the treatment of VVA remains the most pertinent indication for estrogen therapy. When systemic symptoms are absent, estrogen therapy ideally can be administered by a vaginal preparation alone. Systemic estrogen therapy with combined estrogen and progestin in non-hysterectomized women is indicated for women who require treatment for vasomotor and/or other systemic estrogen deficiency symptoms. The improvement in well-being achieved by relief of vasomotor and other symptoms might improve libido in some women and abrogate further intervention. [ABSTRACT FROM AUTHOR]

Highlights: [•] Brief review of normal androgen physiology in women. [•] Causes of low androgen levels in women. [•] Relationship between androgens and sexual function in women. [•] Current evidence for the use of testosterone therapy in women with sexual dysfunction. [•] Other effects of testosterone therapy. [•] Safety concerns. [•] Appropriate candidates for treatment. [ABSTRACT FROM AUTHOR]

The authors’ comment on an article by Bou Khalil who discussed the potential protective role of orgasm in promoting a positive mood in women suffering from depression. They state that through his approach, Khalil explores the potential biological pathways between orgasm and positive mood. The authors’ opine that women with Female sexual dysfunction (FSD) symptoms may improve over time, but sensitive discussion and understanding of her concerns must be part of the psychiatrist’s role.