Women's Sexual Health

Last month we covered general research regarding female and male sexual health. This month we will be focusing on women's sexual health.

More information is coming to light in regard to female sexual dysfunction (FSD). The risk factors for women are cardiovascular disease, neurologic disease, endocrine failure, hypertension and smoking. Men have the same risks. Sexual dysfunction in both sexes can be age-related and progressive.

There are four classifications that are new and fairly controversial for diagnosing FSD. The first is hypoactive sexual desire, in which there is a lack of sexual thoughts and/or receptivity to sexual stimuli. The second is sexual arousal disorder, in which there is poor vaginal lubrication, decreased genital sensation and poor vaginal smooth muscle relaxation. This disorder is often physiological and results from medications, pelvic disorders, or neural and peripheral vascular disease. The third is orgasmic disorder, in which there is a persistent or recurrent loss of orgasmic potential after sufficient sexual stimulation. This may come about after having pelvic surgery or suffering from a spinal cord injury. The fourth is sexual pain disorder, which consists of persistent or recurrent genital pain associated with non-coital sexual stimulation.

Many women think FSD is a normal part of life and an inevitable part of childbirth, aging or menopause. FSD is a physical problem, but because of the delicate nature of this topic, it may become a psychological one if women are afraid to broach the subject with their significant others.

When a woman is in good sexual health, arousal occurs when there is an increase of pelvic blood flow, resulting in vaginal lubrication. Nitric oxide plays a role in stimulating clitoral cavernosal smooth muscle, thereby increasing clitoral blood flow and resulting in genital engorgement.

While men can turn to pharmaceuticals to aid sexual dysfunction--such as sildenafil citrate, otherwise known as Viagra--women cannot. In fact, one recent study indicated that in doses of 10 mg to 100 mg, the pharmaceutical not only did not improve sexual response in women, but resulted in adverse events including headache, nausea and indigestion.

L-arginine, coupled with yohimbe in particular, has been found to make a difference in FSD. When researchers from the University of Texas, Austin, gave 24 postmenopausal women with the disorder a one-time dose of 6 g of L-arginine glutamate along with 6 mg yohimbe HCl, the supplements substantially increased vaginal pulse amplitude responses to an erotic film 60 minutes after administration.

Clinical studies indicate that approximately 45 percent of women between the ages 30 to 45 are seeking stimulating agents to increase their libido--it is possible their sexual desire is diminished due to the stressful lifestyle many women now lead.

For FSD related to stress, relaxation techniques include using various herbs. Results of a study conducted out of the University of Surrey in Guildford, England, indicated that standard dosages of kava and valerian may reduce physiological reactivity such as blood pressure during stressful situations. In a lab animal study, St. John's wort protected against physiological effects of unavoidable stress.

According to researchers at Vancouver Hospital, Canada, when a deficiency in estrogen is involved in a lack of sexual pleasure, estrogen replacement has been shown to be beneficial. As a result, phytoestrogens may be one avenue to go. These natural products may particularly aid menopausal women who are experiencing problems with sexual function. Usually, hormone or estrogen replacement therapies (HRT, ERT) have been the traditional treatment for attempting to alleviate this age-related problem. In fact, for vaginal atrophy associated with menopause, ERT has been found to play a beneficial role, in addition to decreasing coital pain and improving clitoral sensitivity.

Natural estrogen alternatives such as black cohosh, chaste tree berry, dong quai and witch hazel may also aid conditions such as vaginal dryness and dyspareunia. In one study conducted by researchers at the University of Pittsburgh, six months of phytoestrogen supplementation significantly lessened vaginal dryness by the final week of the study.

Researchers out of Sevilla, Spain, highlighted the phytoestrogen soy's isoflavones for sexual health. After 190 postmenopausal women were given 35 mg of isoflavones split into two daily doses for four months, they experienced a significant decrease in vaginal dryness, an improvement in libido and an alleviation of depression--all factors in sexual well-being.

Sometimes, FSD is not caused by estrogen problems, but rather by deficiencies of another hormone--androgen. Androgen levels decline substantially as a woman enters her menopausal years. When women with FSD were given androgen replacement therapy in the form of dehydroepiandrosterone (DHEA), they reported an increase in desire, arousal, lubrication and orgasm. However, side effects included increased facial hair and weight gain.

As you can see by the latest studies on FSD, there is a considerable amount of natural products available to help women. Maybe it is best that there are no pharmaceutical drugs currently available for female sexual dysfunction.

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