A team of experts have made 10 recommendations concerning hormones and female sexual dysfunction (FSD).
The Australian and American researchers were participants in the Fourth International Consultation on Sexual Medicine, held last June in Madrid. They noted that most research on hormones and women’s sexual problems has concentrated on estrogens and androgens.
However, research has expanded over the years and women are being prescribed hormones other than estrogens and androgens off-label or purchasing them directly. With these factors in mind, the research team conducted a literature review of studies concerning the roles of oxytocin, prolactin, and progesterone in FSD and its treatment over the previous twenty years.
They also looked at studies on endocrine disorders that may be involved with FSD, such as polycystic ovary syndrome, pituitary disorders, obesity, metabolic syndrome, and diabetes.
After analyzing the data, the team made the following recommendations:
- There is not enough data for support treating FSD with oxytocin.
- Progestogen-only therapy cannot be recommended.
- Treating hyperprolactinemia might help women with FSD, but data are limited. Premenopausal women with FSD should have their prolactin levels checked.
- Women with hypopituitarism or adrenal insufficiency should not be routinely prescribed testosterone.
- Dehydroepiandrosterone (DHEA) is not appropriate for the treatment of sexual interest-arousal disorder in women with adrenal insufficiency or hypopituitarism.
- Polycystic ovary syndrome (PCOS) may be associated with decreased sexual satisfaction; further research is needed.
- There is not enough information to determine an association between FSD and obesity, but weight loss might help.
- More research is needed on the possible link between metabolic syndrome and FSD.
- Type 1 and type 2 diabetes each increase the risk of FSD.
- Lifestyle interventions that focus on weight loss could improve sexual problems in diabetic women. Phosphodiesterase type 5 (PDE5) inhibitors might help women with type 1 diabetes and sexual arousal disorders.
Other factors, such as depression, iron deficiency, thyroid disease, and galactorrhea (the release of milk from the nipples in women who are not breastfeeding) may also be involved in FSD. Healthcare providers should consider these conditions and take a thorough gynecologic history when assessing women’s sexual problems, the authors explained.
Overall, the hormonal aspects of FSD (aside from estrogens and androgens) has not been well-studied and current understanding “is limited by a paucity of high-quality data,” the researchers wrote.
“Given the availability of these hormones in the marketplace, it is important for clinicians and consumers to be aware of the absence of research into the therapeutic effects of such compounds,” they added.
The study was published last month in the Journal of Sexual Medicine.
Resources
The Journal of Sexual Medicine
Worsley, Roisin, MBBS, FRACP, et al.
“Hormones and Female Sexual Dysfunction: Beyond Estrogens and Androgens—Findings From the Fourth International Consultation on Sexual Medicine”
(Full-text. March 2016)
http://www.jsm.jsexmed.org/article/S1743-6095(15)00049-1/fulltext