New Approaches to Female Sexual Arousal Disorder

May 31, 2002

June 3, 2002 — Topical alprostadil and a clitoral vacuum pump, two new treatments for female sexual arousal disorder (FSAD) presented on May 25 at the American Urological Association annual meeting, improved sexual response by increasing genital blood flow.

"Female sexual dysfunction (FSD) is very common, occurring in 20-50% of the general population, while one survey indicates that 20% of adult women have FSAD," lead author Marc Gittelman, MD, from Uro-medix in Miami, Florida, says in a news release. "To date, there are no FDA-approved pharmacological treatments for this disorder, but topical alprostadil may be an appropriate on-demand treatment for women suffering from FSAD."

In this study, 78 women with FSAD were randomized to receive either topical alprostadil solution, 100 µg or 400 µg, or placebo solution, applied to the clitoris and allowed to spread to the surrounding tissues. All women were either postmenopausal or had received a hysterectomy and bilateral oophorectomy, and all patients had stable hormonal replacement. Treatment was well tolerated with no reports of any significant systemic adverse effects.

Compared with placebo, both doses of alprostadil increased vulvar erythema and edema, suggesting increased localized blood flow. Subjective sexual responses were not dose dependent.

"We are now beginning to address FSD from the perspective that some aspects of FSD are likely caused in part by decreased blood flow to the clitoris or vagina," said Kevin L. Billups, MD, from the EpiCenter for Sexual Health and Medicine in St. Paul, Minnesota. "Poor genital blood flow is believed to contribute to female arousal or orgasm disorders similar to the role of vascular disease in male erectile dysfunction."

Billups described the Eros Therapy, a vacuum-pump device designed to enhance clitoral engorgement, increase blood flow to the clitoris and vagina, and ultimately improve sexual function and satisfaction in women with FSD. His study involved 13 diabetic women who were instructed to use the device at least 4 times weekly as part of a tissue-conditioning routine and at least twice weekly before attempting intercourse. All women had normal testosterone and estradiol levels.

A validated questionnaire demonstrated significant benefit in sensation, lubrication, orgasm, and sexual satisfaction after one month of EROS Therapy and even greater benefit after three months.

"This current study also has implications for non-diabetic women with sexual dysfunction," Billups said.

AUA Annual Meeting: Abstracts 105158,102673. May 25, 2002.

Reviewed by Gary D. Vogin, MD

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