Treatment of Women

Treatment for Women

The clitoris contains cavernosal tissue, much like the penis. Women, like men, require dramatic changes in blood flow to achieve a satisfactory physical climax. Adequate blood flow is necessary for lubrication and erection of the clitoris.

Women are subject to many of the same disease processes which affect male sexual function. In 1978, Frank et al stated that 63% of women reported problems with arousal and orgasm. Unfortunately, research dealing specifically with the physical cause of female sexual dysfunction has lagged behind that directed toward male dysfunction.

There are currently three modes of experimental treatment for female sexual dysfunction:

Education/sex-counseling for patients and partners regarding: female anatomy, arousal and genital engorgement
Hormone replacement directed to restoring levels affected by age, disease or medical treatment
Vascular treatment directed at underlying pathology
- Mechanical devices intended to increase blood flow
  - vibrators
  - specialized low-vacuum clitoral devices
- Topical agents intended to increase capillary blood flow and/or lubrication
- Non-FDA approved and potentially dangerous dietary supplements
  - L-arginine
  - yohimbe

Viagra has not been approved for women. To date, no pharmaceutical manufacturer has applied for FDA approval for the use a PDE-5 inhibitor by women. Research demonstrating the ability of sildenafil and other PDE-5 inhibitors to improve the sexual experience of women is mixed.

Caruso, S. et al. found that sildenafil may improve sexual performance and may indirectly improve other aspects of the sexual life of premenopausal women affected by sexual arousal disorder.
A study by Alatas and Yagci found that sildenafil improves the clitoral and uterine blood flow in healthy postmenopausal women without any erotic stimulus.
Basson, R. et al. found that any physiologic effect of sildenafil was not perceived as improving sexual response in estrogenized or estrogen-deficient women.