Time to realize there is help for female sexual dysfunction

It is defined as a persistent or recurrent problem with sexual desire, response, orgasm or pain. An estimated 40 percent of women have poor interest or enjoyment with sex, depending on age and other life situations (e.g. recent childbirth).

For some reason, it seems we pay a lot of attention to subjects like erectile dysfunction in men, but when it comes to sexual problems that women face, everyone is a little hushed.

No reason to be. So, let’s talk frankly about this important subject, starting with the many things that can contribute to it…

Types and causes of sexual dysfunction

There are various categories of female sexual dysfunction: problems with sexual desire/libido, arousal, lubrication, orgasm, vaginal pain, vaginismus, and more. These are usually caused by one or more of the following:

  • Emotional factors, financial struggle, relationship issues
  • Psychological factors—from body image and self-esteem to past religious indoctrination or sexual trauma
  • Physical stress or just excess fatigue
  • Past gynecological surgery
  • Chronic illnesses such as heart disease, diabetes, arthritis, cancer, depression, incontinence, and more.
  • Menopause and lack of hormones
  • Medication use (e.g. antihypertensives and antidepressants)

You can see that restoring healthy female sexuality might be a bit complicated.

However, for most of you looking for improved sexual health, consider the following medical treatments…

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Treatments that help

Here are some pretty good prescription treatments for low sexual desire and arousal:

  1. Bio-identical Hormone Replacement Therapy using Estradiol + Estriol (“Bi-est”) and Progesterone mimics your natural hormones, essential for muscle tone, skin firmness, hair texture, and sex drive.
  2. Testosterone replacement will boost sexual desire and arousal. The main side effects reported in clinical trials are increased facial hair (a.k.a. hirsutism) and acne, although acne is not seen with testosterone cream. Hirsutism is dose-dependent and can be managed with a number of natural supplements or medications.
  3. Sildenafil (Viagra) can be used for women: approximately 20 mg per dose would be equivalent to 50 to 100 mg in men. When blood flow is increased to the genitalia, so is arousal and the ability to perform sexually.  In women, Viagra causes swelling in the clitoris and vulva, initiates natural lubrication, and increases sexual tissue sensitivity. It needs to be taken 30 minutes or so before beginning sexual activity for it to be effective.
  4. Wellbutrin (bupropion) is useful for psychology-induced female sexual dysfunction. You know this also as an anti-depressant and smoking-cessation medicine.
  5. Alprostadil topical cream. This medicine has been by injection for male erectile disorder, but a new formulation of alprostadil topical cream 0.4 percent (Femprox, Apricus Biosciences Inc) significantly improved female sexual arousal disorder in younger and also postmenopausal women. This was reported in a randomized, placebo-controlled, phase 3 study.
  6. Apomorphine (Uprima): stimulates dopamine production, which gives easier and better-quality erections men and libido for women. Dissolve it under your tongue and begin sexual activity in 20 minutes.

These will help with vaginal dryness/painful sex:

  1. Lubrication
  2. BHRT (see above) applied vaginally for increased saturation in genital organs

This is known to increase the feelings of bonding and also arousal:

  1. Oxytocin: is the neuro-hormone of bonding, and is involved with the formation of loving relationships; also referred to as “love hormone”—it is released when we hug, touch, and experience orgasm. Interestingly, taking Viagra has been shown to cause oxytocin release from the brain.

Related: 5 natural ways to boost your libido

In my next article, I’ll discuss the natural treatments for female sexual dysfunction including the neurochemical supplements dopamine (for desire and libido), acetylcholine (for arousal), GABA (to calm anxiety) and serotonin enhancers (for a good mood), among other natural supplements. I’ll also share about the PRP shot that can be magical for desire, arousal, and orgasm.

To sexual health and relationships,
Michael Cutler, M.D.


  1. Shufelt CL, Braunstein GD. Safety of testosterone use in womenMaturitas. 2009 May 20;63(1):63-6. PubMed PMID: 19250779
  2. Alprostadil for women — Alprostadil Reviews
Dr. Michael Cutler

By Dr. Michael Cutler

Dr. Michael Cutler is a graduate of Tulane University School of Medicine and is a board-certified family physician with more than 20 years of experience. He serves as a medical liaison to alternative and traditional practicing physicians. His practice focuses on an integrative solution to health problems. Dr. Cutler is a sought-after speaker and lecturer on experiencing optimum health through natural medicines and founder of the original Easy Health Options™ newsletter — an advisory on natural healing therapies and nutrients. His current practice is San Diego Integrative Medicine, near San Diego, California.