Pharmacologic therapeutic options for sexual dysfunction.

Current opinion in obstetrics & gynecology2022PMID: 36036468

View on PubMed DOI: 10.1097/GCO.0000000000000821

Plain Language Summary

Reviews pharmacologic options for sexual dysfunction including HSDD and genitourinary syndrome of menopause. Covers bremelanotide and flibanserin as the central options for desire disorders, discussing their different mechanisms, clinical evidence, and how safety data has strengthened over recent years. Provides guidance for clinicians treating the 45% of women reporting sexual problems.

Abstract

PURPOSE OF REVIEW: Sexual problems are reported by up to 45% of individuals assigned female at birth. Although sexual function is a complex biopsychosocial construct, there are a number of pharmacologic treatment options aimed at addressing the changing vaginal hormonal milieu in postmenopausal individuals and moderating the excitatory and inhibitory aspects of the central nervous system in those with hypoactive sexual desire disorder. RECENT FINDINGS: The last decade has seen an increase in the number and type of pharmacologic treatment options for dysfunction primarily associated with menopause and hypoactive sexual desire disorder. Recent publications and systematic reviews have strengthened the safety data of existing FDA-approved medications as well as off-label therapies. SUMMARY: Pharmacologic treatment with local estrogen and testosterone replacement in postmenopausal individuals and with centrally-acting therapies such as flibanserin, bremelanotide, and testosterone in premenopausal individuals assigned female at birth are safe and can be used to improve sexual desire and sexual satisfaction.

Authors

Burton, Claire S; Mishra, Kavita