Drugs of limited use in female sex dysfunction.(Gynecology)

YOSEMITE, CALIF. -- Most of the research on drug treatment of female sexual desire disorder and sexual arousal disorder has shown modest or no benefit and suggests limited application, Dr. Mary C. Ciotti said at a meeting on obstetrics and gynecology sponsored by Symposia Medicus.

For most patients, low libido or problems with arousal have a multifactorial origin, so medication is likely to be only part of the solution, said Dr. Ciotti of the University of California, Davis.

Many women, however, will want to give medication a try. Pharmacologic levels of testosterone have been shown to increase libido. This agent may help some women, although its use should probably be limited to postmenopausal women because it has not been well studied in premenopausal women and, in the few studies that have been conducted in this population, it has not been shown to be beneficial, Dr. Ciotti said.

Even with postmenopausal women, however, clinicians should not expect improvement with many patients. The treatment is probably going to be empiric, based on an overall clinical impression, since laboratory measurements of testosterone are not very meaningful. That means you won't really know if the patient's testosterone level is deficient or what dosage you need to restore her libido, Dr. Ciotti said at the meeting.

In her experience a trial of testosterone treatment often is not successful. Moreover, the study in postmenopausal women that showed the most significant increase in well-being and libido was conducted in women who had undergone surgical menopause and used a patch (Intrinsa, Procter & Gamble Pharmaceuticals) that is not yet approved in the United States (N. Engl. J. Med. 343[10]:682-88, 2000).

Estratest is the one approved testosterone replacement medication for U.S. women, containing conjugated estrogen and 1.25 mg or 2.5 mg of methyltestosterone. Estratest is approved only for the treatment of ...