The female sexual response cycle is a complex system composed of physiologic changes, psychological, and cultural factors. Female sexual dysfunction (FSD) encompasses a variety of sexual problems, including low desire or interest, diminished arousal, difficulties with orgasm, and dyspareunia. Research in female sexual function and dysfunction has lagged significantly behind males despite our current knowledge that FSD can occur in as many of 80% of the female population. Basic science research exists but also identifies serious gaps in our fundamental knowledge of this area. The purpose of this article was to review our current understanding of the effects of hormones on normal physiologic sexual responses in women, female sexual function and dysfunction, and the available treatment options for the various components of FSD.
Significant progress remains to be made in the field of FSD. Although the classification and definitions continue to evolve, it is essential to continue investigating the role of sex steroid hormones in both the diagnosis and the treatment of FSD. A better understanding of the biochemical, cellular, and physiological mechanisms that these hormones have in modulating sexual function will improve our understanding of how to diagnose and treat patients with this condition. Although several hormonal therapies, supplements, and devices now exist to improve various aspects of FSD, we are still in need of future studies to determine appropriate and efficacious first-line agents with minimal adverse effects for the treatment of female sexual dysfunction.
From the Division of Female Pelvic Medicine and Reconstructive Surgery,Department of Obstetrics & Gynecology, Women's Health, and Urology,Albert Einstein College of Medicine/Bronx Lebanon Hospital Center, Bronx, NY.
Reprints: Magdy S. Mikhail, MD, Division Director, Female Pelvic Medicine and Reconstructive Surgery, Albert Einstein College of Medicine, Bronx Lebanon Hospital Center, 1650 Grand Concourse, Bronx, NY 10467. E-mail: Mikhailgyn@aol.com; firstname.lastname@example.org.