Evaluation and management of female sexual dysfunction

This article presents an overview of the etiology, prevalence, classification, and recent treatment modalities for female sexual dysfunction (FSD). Many anatomic, hormonal, and psychological factors adversely affect female sexual health and contribute to the diverse etiologies of this condition. Gonadal hormones play a key role in the maintenance of sexual health, with estrogens contributing to genital health and androgens contributing to sexual desire and fantasy. With aging, both estrogen and androgen levels decrease in the female, resulting in an increase in sexual pain problems and diminished libido. However, addressing only hormonal etiologies of FSD while disregarding other contributors may result in failure to adequately treat this ubiquitous condition to the woman's and, in many instances, the couple's satisfaction. Like in the management of medical conditions with multifactorial etiologies, there is no single intervention leading to adequate treatment of women who report sexual dysfunction. As well, several interventions may be necessary to treat the sexual dysfunction. For example, optimal treatment of diminished sexual desire may necessitate not only androgen use, but also couple's counseling.