Effectiveness of Topical Alprostadil for the Treatment of Female Sexual Arousal Disorder

Background: Female sexual dysfunction (FSD) is a vast problem in the medical community and in the world. It affects more than just sexual experiences of women and their partners, but also vitality and many other aspects of health. Female Sexual Arousal Disorder (FSAD) is one subcategory of FSD disorders. Since arousal has been found to be a key component in the female sexual response cycle, possible treatments would ideally target local arousal. Topical alprostadil has been proposed to be a vasodilator and could possibly affect chemoreceptors locally in the genitalia. Thus, it is a probable treatment for the many women who live with FSAD. Methods: An exhaustive search of available medical literature was conducted utilizing MEDLINE-Ovid, CINAHL, and Web of Science. Keywords used to search were alprostadil, sexual dysfunction and female. GRADE was utilized to evaluate the evidence Results: Two journal articles were found that met all the inclusion and exclusion criteria. A dose related response was found for improvement of FSFI scores, sexual arousal rates, and sexual satisfaction vs. placebo in both studies. The rates of sexual arousal and sexual satisfaction were significantly higher in the 400 mcg group in the Heiman et al, 2006 study and the 900 mcg group of the Liao et al, 2008 study. Adverse events were low in all treatment groups, and lowest in the placebo, 100 mcg, 500 mcg and 700 mcg groups respectively. Conclusion: Topical alprostadil is an effective and safe treatment option for patients with FSAD. This treatment significantly improved sexual arousal rates and sexual satisfaction for most all treatment groups. Keywords: Alprostadil, female sexual dysfunction, female sexual arousal disorde