1237 -- 9/3/02
FEMALE SEXUAL DYSFUNCTION
Gabe Mirkin, M.D.
According to several research papers, more than 90 percent of middle-aged women suffer from decreased
desire to make love, not being aroused by sexual stimuli, or inability to climax. An article in the Mayo Clinic Proceedings
summarizes the accepted treatment plan for this condition, called Female Sexual Dysfunction.
Lack of desire is associated with poor health, overwork, lack of privacy, or failure to be in
a caring relationship. It is also associated with depression, certain medications and drugs, and low blood levels of the male
hormone, testosterone. According to the study, 87 percent of married women claim that they have decreased desire, 83 percent
find it very difficult to climax, 74 percent lubricate poorly, and 71 percent have discomfort on making love.
Every woman who feels that she has Female Sexual Dysfunction should realize that hundreds of
different medications can prevent a woman from having desire or being able to climax: antihistamines, blood pressure medications,
antibiotics, cancer drugs, stomach and intestinal medications, contraceptives, sleeping pills, antidepressants, alcohol, recreational
drugs, and all the antiestrogens such as tamoxifen and Lupron. It is very common for women to lose interest in making love
after they have had their ovaries removed because a woman's ovaries continue to produce large amounts of male hormones for
her entire life. Many women who have had their ovaries removed require testosterone to increase their sexual desire.
Many products on the market today are sold to increase sexual desire; they often have some variation
of Viagra in their names. Many products claim that they contain yohimbine that increases sexual desire. Several studies show
that yohimbine is not more effective than a placebo, so nobody should waste money buying products that claim that they contain
yohimbine to improve sexual desire or performance.
There is no evidence whatever that Viagra increases sexual desire in women or in men. Viagra
helps a man achieve an erection by increasing blood flow to the penis. It fills a woman's pelvic organs with blood. Since
vaginal secretions come from the bloodstream, Viagra will increase vaginal secretions, even though it does not increase desire.
The common cold medicine called ephedrine also increases vaginal secretions and can be used to increase lubrication. Prescriptions
containing phentolamine can markedly increase vaginal lubrication.
The most common cause of a dry vagina after stimulation is a vaginal infection that should be
treated with the appropriate medication to kill the offending germ, whether it is herpes, chlamydia, mycoplasma, ureaplasma,
gonorrhea, the wart virus, yeast, or intestinal bacteria.
Every women who suffers from decreased sexual desire, decreased arousal or lack of orgasms should
get blood tests for testosterone and DHEAS. Testosterone is the male hormone produce by the ovaries, and DHEAS is the male
hormone produced by the adrenal glands. Testosterone can increase sexual desire, even in women who have normal or high levels
of that hormone.
The majority of women over age 50, and many under 50, cannot climax with penile-vaginal lovemaking
because the vagina is not the source of an orgasm, the clitoris is. It takes continual and prolonged stimulation of the clitoris
for most older women to achieve an orgasm. A vibrator can provide this stimulation if other techniques are not effective.
Recently, the Food and Drug Administration of the United States approved a hand-held, battery-operated,
device with a small plastic cup that applies a very gently vacuum to the clitoris. It has been shown to make the clitoris
larger temporarily by filling the clitoris with blood. It also increases vaginal secretions and improves a woman's ability
to climax.
Mayo Clin Proc July,2002.
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