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Treatments and drugs
By Mayo Clinic staffWomen with sexual concerns benefit from a combined treatment approach that addresses medical as well as emotional issues. Occasionally, there's a specific medical solution — using vaginal estrogen cream, for example, or switching from one antidepressant medication to another. More often, behavioral treatments — such as couple's therapy and stress management — are needed to address the roots of female sexual dysfunction. And sometimes, a combination approach works best.
Nonmedical treatment for female sexual dysfunction
You can improve your sexual health by enhancing communication with your partner and making healthy lifestyle choices.
- Talk and listen. Some couples never talk about sex, but open and honest communication with your partner can make a world of difference in your sexual satisfaction. Even if you're not used to communicating about your likes and dislikes, learning to do so and providing feedback in a nonthreatening manner can set the stage for greater sexual intimacy.
- Practice healthy lifestyle habits. Avoid excessive alcohol. Drinking too much will blunt your sexual responsiveness. Also, stop smoking and start exercising. Cigarette smoking restricts blood flow throughout your body, and less blood reaching your sexual organs means decreased sexual arousal and orgasmic response. Regular aerobic exercise can increase your stamina, improve your body image and elevate your mood, helping you feel more romantic, more often. Finally, don't forget to make time for leisure and relaxation. Learning to relax amid the stresses of your daily life can enhance your ability to focus on the sexual experience and attain better arousal and orgasm.
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Strengthen pelvic muscles. Pelvic floor exercises can help with some arousal and orgasm problems. Doing Kegel exercises strengthens the muscles involved in pleasurable sexual sensations. To perform these exercises, tighten your pelvic muscles as if you're stopping your stream of urine. Hold for a count of five, relax and repeat. Do these exercises several times a day.
Your doctor also may recommend exercising with vaginal weights — a series of five weights, each increasingly heavier, that you hold in place in your vagina — to strengthen pelvic floor muscles. You gradually work up to heavier weights as your muscle tone improves.
- Seek counseling. Talk with a counselor or therapist specializing in sexual and relationship problems. Therapy often includes education about normal sexual response, ways to enhance intimacy with your partner, and recommendations for reading materials or couples exercises. With a therapist's help, you may gain a better understanding of your sexual identity, beliefs and attitudes; relationship factors including intimacy and attachment; communication and coping styles; and your overall emotional health.
Medical treatment for female sexual dysfunction
Effectively treating sexual dysfunction often requires addressing an underlying medical condition or hormonal change that's affecting your sexuality.
Treating female sexual dysfunction tied to an underlying medical condition might include:
- Adjusting or changing medications that have sexual side effects
- Treating thyroid problems or other hormonal conditions
- Optimizing treatment for depression or anxiety
- Strengthening pelvic floor muscles
- Trying strategies recommended by your doctor to help with pelvic pain or other pain problems
Treating female sexual dysfunction linked to a hormonal cause might include:
- Estrogen therapy. Localized estrogen therapy — in the form of a vaginal ring, cream or tablet — can improve sexual function in a number of ways, including improving vaginal tone and elasticity, increasing vaginal blood flow, enhancing lubrication, and having a positive effect on brain function and mood factors that impact sexual response.
- Progestin therapy. In some research studies, women taking progestins experienced a decrease in sexual desire and vaginal blood flow. However, in other studies, women experienced improvements in desire and arousal when they took progestin in addition to estrogen. More studies are under way to see if different progestin regimens, alone or in combination with estrogen and other hormonal agents, may benefit sexual function. Progestins generally are prescribed to balance estrogen's effect on the uterus and not to treat female sexual dysfunction.
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Androgen therapy. Androgens include male hormones, such as testosterone. Testosterone is important for sexual function in women as well as men, although testosterone occurs in much lower amounts in a woman. Androgen therapy for sexual dysfunction is controversial. Some studies show a benefit for women who have low testosterone levels and develop sexual dysfunction, other studies show little or no benefit.
Testosterone may be given as a cream or gel patch applied to your skin. Sometimes, testosterone is given as a pill or injection. Side effects, such as acne, excess body hair (hirsutism), enlargement of the clitoris, and mood or personality changes, are possible. Because long-term effects of testosterone therapy in women aren't known, you should be closely monitored by your doctor.
Hormonal therapies won't resolve sexual problems that have causes unrelated to hormones. Because the issues surrounding female sexual dysfunction are usually complex and multifaceted, even the best medications are unlikely to work if other emotional or social factors remain unresolved.
Emerging treatments
Tibolone is a drug currently used in Europe and Australia for treatment of postmenopausal osteoporosis. In a small study, women taking the drug experienced an increase in vaginal lubrication, arousal and sexual desire. But Tibolone hasn't yet received Food and Drug Administration (FDA) approval for use in the U.S.
