Female sexual dysfunction (FSD) affects approximately 40 million American women and is more prevalent in women than men, with prevalence increasing with age. Conditions such as hypoactive sexual desire disorder, sexual aversion disorder, and orgasmic disorder each represent different manifestations of FSD, while treatment options include behavioral techniques, medication, and surgery. Notably, testosterone plays a significant role in sexual drive, and interventions may range from addressing psychological barriers to utilizing pharmacological agents like sildenafil citrate.

1. Female sexual dysfunction
Sapkota, Rajita

2. Sexual dysfunction is more prevalent in women (43%)
than in men (31%and increases as women age.
Married women have a lower risk of sexual dysfunction
than unmarried women.
Approximately 40 million American women are affected
by FSD.

3. In adults, alterations in circulating levels of gonadal hormones
(estrogen, progesterone, and testosterone) can affect sexual
interest and expression.
Estrogen is only minimally involved in libido, menopause (i.e.,
cessation of ovarian estrogen production).
Aging do not reduce sex driveif a woman’s general health is
good.
Testosterone is secreted by the adrenal glands (as well as the
ovaries and testes) throughout adult life and is believed to play an
important role in sex drive in both men and women.

4. Hypoactive sexual desire disorder :Decreased interest in sexual
activity.
Sexual aversion disorder: Aversion to and avoidance of sexual activity.
Female sexual arousal disorder: Inability to maintain vaginal
lubrication until the sex act is completed, despite adequate physical
stimulation (reported in as many as 20% of women).
Orgasmic disorder:
Lifelong: has never had an orgasm
Acquired: is currently unable to achieve orgasm despite adequate
genital stimulation and normal orgasms in the past
Reported more often in women than in men
Vaginismus: Painful spasms occur in the outer third of the vagina, which
make intercourse or pelvic examination difficult.
Dyspareunia: Pain during intercourse

5. Treatment of sexual problems may be behavioral, medical, or
surgical.
Behavioral treatment techniques
sensate-focus exercises
used to treat sexual desire, arousal, and orgasmic disorders
the individual’s awareness of touch, sight, smell, and sound
stimuli are increased during sexual activity, and psychological
pressure to achieve an erection or orgasm is decreased.
Relaxation techniques, hypnosis, and systematic desensitization
used to reduce anxiety associated with sexual performance.
Masturbation may be recommended to help the person learn what
stimuli are most effective for achieving arousal and orgasm.

6. Medical and surgical treatment
Systemic administration of opioid antagonists (e.g., naltrexone)
and vasodilators (e.g.,yohimbine) have been used to treat erectile
disorder.
In erectile disorder, sildenafil citrate (Viagra) and related agents
work by blocking an enzyme (phosphodiesterase-5) that destroys
cyclic guanosine monophosphate (cGMP), a vasodilator secreted in
the penis with sexual stimulation.
Intracorporeal injection of vasodilators(e.g., papaverine,
phentolamine) or implantation of prosthetic devices are also used to
treat erectile dysfunction.
Apomorphine hydrochloride(Uprima) increases sexual interest and
erectile function by increasing dopamine availability in the brain.