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Sexual Arousal Disorder: "I Just Can't Get Excited"

Overcoming Sexual Arousal Disorder

Until the Bermans and other advocates of women's sexual health arrived on the scene, all women had to combat SAD were vaginal lubricants like KY-jelly, which eases symptoms but does not address the underlying problem.

Now, clinical trials are underway to evaluate the efficacy of medications like Viagra to successfully treat SAD and some other types of female sexual dysfunction. The Bermans have worked tirelessly to help determine the best candidates for the trial.

Notes Dr. Jennifer Berman: "In the studies, probably 80 to 90 percent of women with arousal problems noted enhanced sensation, lubrication and engorgement" with Viagra.

Two Approaches to Sexual Arousal Disorder

Basically, there are two approaches to treating SAD: hormone replacement therapy (HRT) and increasing blood flow to the pelvic tissues.

  • HRT: Conventional hormone replacement therapy—estrogen combined with a synthetic version of the hormone progesterone—is typically used to treat decreased estrogen levels associated with dryness, thinning and irritation of the vagina. You don't have to take Premarin, the best-selling drug in the United States for estrogen; in fact, for SAD you may want an estradiol vaginal ring (Estring), which is placed in the vagina for 90 days at a time. Another local vaginal delivery system is Vagifem, a tablet that you insert into your vagina daily for two weeks, followed by twice a week thereafter. These two options are easiest to use and less messy than vaginal creams, note the Bermans.
  • Increasing blood flow: To help increase blood flow and improve genital sensation, the Bermans often prescribe 2 percent testosterone cream, which you apply at least three times a week at bedtime to the clitoris and inner labia. (Libido problems associated with hypoactive sexual disorder are better treated with oral testosterone.) The Bermans also often recommend the prescription drug Viagra. Viagra helps to engorge the vagina with blood, causing it to become properly lubricated, much the same way it causes the blood vessels in a man's penis to become engorged, which produces an erection.