Sexual health

Given the success of drugs to treat erectile dysfunction, such as sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra, Staxyn), drug companies have sought a similar drug for women.

Viagra has even been tried as a treatment for sexual dysfunction in women. However, the U.S. Food and Drug Administration (FDA) hasn't approved this use of Viagra.

Indeed, for many years there were no FDA-approved drugs for treating problems with sexual arousal or sexual desire in women. Yet 4 in 10 women report having sexual concerns. The FDA has now approved two medications.

The FDA has approved a daily pill called flibanserin (Addyi) — originally developed as an antidepressant — as a treatment for low sexual desire in premenopausal women.

Addyi may boost sex drive in women with low sexual desire who find the experience distressing. Potentially serious side effects include low blood pressure, dizziness and fainting. These side effects may occur especially if the drug is mixed with alcohol. The FDA recommends avoiding alcohol use if you take this drug. Experts recommend that you stop taking the drug if you don't notice an improved sex drive after eight weeks.

The FDA has also approved an injectable medication, bremelanotide (Vyleesi), as a treatment for low sexual desire in premenopausal women. The medication should be injected in the stomach (abdomen) or thigh at least 45 minutes before anticipated sexual activity. It shouldn't be used more than once a day or more than eight times a month. Potential side effects can include nausea, headache, vomiting and reactions at the injection site. Talk to your health care provider for more information about whether this might be an option for you.

Female sexual response is complex. Sexual problems may be due to difficulties with arousal, a lack of desire or both. Many factors can influence sexual desire in women. For example:

• Many women find that the stresses of daily life reduce their desire for sex.
• Highs and lows in sexual desire may coincide with the beginning or end of a relationship, or major life changes, such as pregnancy or menopause.
• For some women, orgasm can be difficult to achieve — causing concerns or preoccupations that lead to a loss of interest in sex.
• Desire is often connected to a sense of intimacy between partners, as well as past experiences. Over time, mental health troubles can impact biological problems and vice versa.
• Some chronic conditions, such as diabetes or multiple sclerosis, can change the sexual-response cycle — causing changes in arousal or orgasmic response.

If you're experiencing changes or difficulties with sexual function, talk to your health care provider. Your provider may recommend consulting a sex therapist. In some cases, medications, hormones, creams, lubricants, clitoral stimulation or other treatments may be helpful.

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