Female sexual dysfunction: review of the disorder and evidence for available treatment alternatives

With the introduction and marketing of sildenafil, national attention has focused on sexual dysfunction in men. How-ever, strides are being made to focus more effort on evalua-tion and treatment of female sexual disorder (FSD) since a 1999 national survey reported prevalence rates as high as 43 % inwomen. Evaluation and assessment of FSD requires a comprehensive history and physical examination. Under-standing of FSD requires knowledge and understanding of sexual anatomy, physiology, and pathophysiology. Nonpharmacologic treatment may include sex therapy or re-lationship counseling. Pharmacologic treatment of FSD has focused mainly on hormonal therapies, including estrogen and testosterone, with the majority of studies being done in postmenopausal and hysterectomized women. However, re-cent studies indicate a more prudent and careful use of hor