Female Sexual Dysfunction (FSD) is a medical condition that has received little attention, until recently. FSD is a broad term used to describe low sex drive, difficulty in achieving an orgasm, inability to attain and maintain lubrication and lack of arousal during sexual activity. The field of study for this and other sexual dysfunctions, although still in its infancy, is growing with promising treatments and therapies every day. With increased awareness of women's health issues, FSD is being discussed more openly.

Dr. Stanley Zaslau, Urologic Surgical Associates, and Assistant Attending, Division of Urology Maimonidies Medical Center, reports that more than 43 percent of American women (approximately 40 million) experience some form of sexual disorder. Zaslau also states that with the advent and popularity of sex-enhancing drugs for men a few years ago, it became clear that women's sexual problems and issues and their lack of "sexual satisfaction" has been largely ignored by the medical community. Welcome to the year 2001 - a time when women are asking for and demanding more effective solutions for their own sexual concerns.

Treatment Options for Female Sexual Dysfunction

Sexual Dysfunction is still investigational and includes: topical lubricants, nutraceuticals, sildenafil (Viagra), a clitoral stimulation device and topical estrogen therapy. A sexually stimulating personal lubricant, such as ProSensual, composed of soy bean oil and a variety of stimulants, has been suggested to increase vaginal blood flow and improve clitoral sensation.

Nutraceuticals containing L-arginine and yohimbinc have been shown to increase sexual desire and arousal in another study with limited follow up. Sildenafil has shown promise in sexual dysfunction associated with depression in patients taking the serotonin-reuptake inhibitors. The clitoral stimulation device has been shown to improve clitoral sensation, increase lubrication and improve the ability to achieve orgasm in women with Female Sexual Dysfunction as well as women with diabetes and FSD.

Topical estrogen therapy has been shown to be beneficial to women with atrophic vaginitis who also complain of FSD. According to data from a Women's Sexual Health Clinic in Boston, characteristics of the first 200 women evaluated are now available. The mean age at time of presentation is 42 years including 21 percent who underwent natural or surgical menopause. Patients had symptoms of sexual dysfunction for a mean of 8 years prior to presentation. Regarding exposure history, approximately 4 percent of patients had hypertension, 4 percent diabetes mellitus, 10 percent hypercholesterolemia and 8 percent were cigarette smokers. The most common sexual complaint was diminished desire, arousal and orgasmic difficulties in 60 percent. Sexual pain was a complaint in 19 percent (most of which was due to prior trauma).

The elements of the history of a woman with a sexual complaint can follow the same pattern that for other gynecological problems. The onset, course, duration, aggravating and alleviating factors, associated symptoms, the general medical history and complete review of symptoms as well as stressful life situations must be carefully defined and reviewed. For example, if intercourse is painful, it must be defined and reviewed, which can be determined by asking, "Where exactly does it hurt and at what point?" If anorgasmia is of concern, this must be furthered examined by asking, "Is the patient anorgasmic during sexual intercourse because she is not aroused enough?" "Does she have a low libido?" "Is this a true decrease in libido or does she have a sexual appetite difference as compared with her partner?" The onset of the problem should be explored: How did it start? Was it sudden or gradual? Has the patient discussed the problem with any other health care professional? Aggravating and alleviating factors are also important: Is there a problem all of the time? Is it positional? Is it related to social factors (young kids at home)? Associated symptoms are also important: Are there symptoms of thyroid disease or elevated prolactin? Is the menstrual cycle regular? What type of contraception is being used? Are there any symptoms of depression? Is there a prior history of pelvic surgery?

Physical Examination

Blood pressure, height and weight should be taken in all patients. If the patient is under weight, consider an eating disorder or anorexia. Both of these conditions are associated with hypoestrogenemia. Palpation of the thyroid gland is important to rule out thyroid disease. Acanthosis nigricans, a thin velvety darkening of the skin of the back of the neck is seen in patients with diabetes mellitus. Breast examination is important in the patient complaining of breast pain and to rule out galactorrhea. Cushing's syndrome can also lead to depression and female sexual dysfunction. Pelvic examination is particularly important. The urethra and labia minora/majora need to be examined for evidence of Human Papilloma Virus infection and small areas of condyloma. Patients with Chrohn's disease may have vaginal ulcerations.

ProSensual is recommended by physicians and sex therapists for women who experience symptoms of Female Sexual Dysfunction and Female Sexual Arousal Disorder, broad terms used to describe low sex drive, failure to attain or maintain lubrication and subjective sense of excitement during sexual activity, difficulty in achieving orgasm and inability to become sexually aroused. ProSensual is an all-natural, soy-based topical personal lubricant that is safe, effective, fast acting and easy to use. The only product of its kind, research suggests that ProSensual activates nerves in the labia and clitoris to heighten sensation minutes after application. ProSensual is absorbed by the tissues of the female genital area, which are permeable to topical agents. This new sex-enhancing lubricant was co-developed by Howard Schiff, M.D., a urologist specializing in women’s health.

This is a time when women are re-examining the quality and happiness of their sex life, mainly due to the introduction and popularity of sex-enhancing drugs and devices. This is the year of the new 'sexual revolution' - women are more open about sex and seeking a more healthy and balanced sex life, states Amy Golan, co-founder, ProSensual. "Our research indicates that women are seeking natural ways to better enhance their sexual experiences for themselves and their partners. ProSensual helps women feel more sexually aroused faster and with less effort. This product is ideal for women of all ages, particularly those who experience difficulties in becoming sexually aroused."