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Women's Health
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Sexual health has many benefits physical well-being, reduced stress, enhanced immune system, improved self-esteem and a better quality of life, to name a few. In recent years, the introduction of Viagra and similar drugs has revolutionized men’s sexual ability. Women’s sexual health has not seen the same research breakthroughs. To date, the Food and Drug Administration (FDA) has not approved a medication for female sexual dysfunction. Also, the recent controversy about hormonal therapy makes it more difficult to do studies on women’s sexual health. Low sexual desire is the most common sexual complaint, affecting an estimated 30-40% of women. Other sexual complaints include problems with arousal, orgasm, and pain with sexual activity. There are four medically recognized categories related to female sexual dysfunction: sexual desire disorders, arousal disorder, orgasmic disorder and sexual pain disorders. There are many reversible or treatable causes. Sexuality, desire, arousal and orgasm are part of a very complex process. All of the following affect sexual health: • Quality of relationship • Religious/moral upbringing • Peer group • Age/hormonal status • Past experiences • Illness/medication • Emotional well-being and body image If I could bottle the most effective, guaranteed sexual enhancer, it would include equal parts of positive body image, self-esteem, a quality relationship, communication with one’s partner, and TIME! Since these are not readily available at the drugstore, let’s review what has been proposed. Viagra Despite the dramatic effect in men, the drug provides no significant improvement in female sexual health, specifically in libido. There is a theoretical potential for benefit in women with poor genital blood flow, but there has not been any conclusive benefit shown in more than 3,000 women studied. Testosterone Citing the need for more long-term safety data, the FDA in December 2004 rejected the first proposed transdermal testosterone patch for the treatment of hypoactive (low) sexual desire disorder, despite the promising improvement in surgically postmenopausal women. The current FDA-approved testosterone products are dosed for men, but are often used “off-label” with varying success by women to treat decreased desire, arousal, orgasm, and vaginal dryness. Monitoring by a physician is important because too much testosterone can produce masculine-like effects, including acne, excessive facial and body hair, voice changes and changes in cholesterol. Estratest Estratest, a combination of estrogen and testosterone, is FDA approved for the treatment of hot flashes. Although it has not been approved for treating hypoactive sexual desire, some studies report improvement in sexual satisfaction and desire in postmenopausal women. Like all estrogens and hormone therapies, the risks including blood clots and stroke must be weighed and monitored by a physician. Wellbutrin Wellbutrin is an antidepressant that may boost sexual drive. There have been no large studies, but smaller studies in premenopausal women have reported satisfaction with sexual experience and drive. Improvement in depression would likely improve sexual desire. Also, many of the other antidepressants decrease sexual drive, arousal and orgasm, so changing from one of those to Wellbutrin may have an effect. Herbal remedies ArginMax is an oral supplement with a blend of damiana, L-arginine, ginseng and gingko biloba. It is one of the few herbal preparations with scientific research, showing an improvement in sexual satisfaction in 74% of women studied. Other improvements reported were in desire, lubrication, and sensation/orgasm. Caution: Gingko biloba may interact with blood thinners. Avlimil is another herbal product that markets improvement in sexual desire. There have no published studies on its effectiveness or safety. Zestra is a blend of botanical oils, including borage seed oil, primrose oil, extract of angelica, and antioxidants. A small but well-designed scientific study of Zestra produced promising results for increasing arousal. There are no long-term safety studies on any of these preparations, and they are unregulated by the FDA. It is important to discuss with your physician all of the supplements you take. Lubricants and devices Lubricants can help with dryness, improve sensation and decrease discomfort associated with dryness. There are a variety of formulations water-based/glycerin-based, water-based/glycerin-free, silicon-based, petroleum-based, and oil-based so read labels. Eros therapy is the only FDA-approved device for arousal and orgasmic disorder. It applies a gentle vacuum to the clitoris and improves blood flow and sensation. Other devices are available and should be used with common sense. There are no quick and easy remedies to enhance sexual drive, arousal and orgasm. The first step to a healthier sex life is recognizing that female sexuality is complex and influenced by physical, emotional and social factors. Make time for activities that bring you and your partner closer, and remember to discuss options with your physician. Dr. Patricia A. Wallace is a board-certified OB/GYN at UCI Medical Center, Orange County’s only university hospital, which has been named one of the nation’s best hospitals for gynecology by U.S. News & World Report. Information: www.ucihealth.com or call 714.456.2911. |
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