Treatments for female sexual dysfunction depends on the specific problem (low desire, difficulty with arousal, orgasm problems, pain during sex, or a combination). Most experts use a biopsychosocial approach, addressing medical, hormonal, psychological, and relationship factors together.
Low Sexual Desire (Hypoactive Sexual Desire)
Lifestyle and Medical Optimization
- Review medications that may reduce libido (e.g., some antidepressants, hormonal contraceptives)
- Improve sleep, exercise, and stress management
- Treat underlying conditions such as:
- Depression
- Diabetes Mellitus
- Hypothyroidism
Psychological and Relationship Therapy
- Sex therapy
- Cognitive behavioral therapy (CBT)
- Couples counseling
- Mindfulness-based interventions
Medications
For selected women with acquired, generalized low sexual desire:
- Flibanserin
- Approved in some countries for premenopausal women with hypoactive sexual desire disorder (HSDD)
- Taken daily
- Bremelanotide
- Injectable medication used before anticipated sexual activity
- Approved in the United States for certain women with HSDD
Testosterone Therapy
- Sometimes prescribed off-label for postmenopausal women with low desire
- Usually considered only after careful evaluation
- Requires monitoring for side effects
Arousal Disorders
Women may have adequate desire but difficulty becoming physically aroused.
Treatment may include:
- Sex therapy and education
- Pelvic floor physiotherapy
- Lubricants and moisturizers
- Treatment of hormonal deficiencies
- Addressing medications or medical conditions affecting blood flow or nerve function
Vaginal Dryness and Menopause-Related Symptoms
Common after menopause due to reduced estrogen.
Non-Hormonal Options
- Vaginal moisturizers
- Water- or silicone-based lubricants
Hormonal Treatments
- Local vaginal estrogen preparations
- Vaginal estrogen creams, tablets, or rings
These can be particularly effective for:
- Dryness
- Pain during intercourse
- Vaginal atrophy
Other Options
Pain During Intercourse (Dyspareunia)
Treatment depends on the cause.
Possible approaches include:
- Treatment of infections
- Hormonal therapy for vaginal atrophy
- Pelvic floor physical therapy
- Pain management strategies
- Counseling when pain has psychological or relational components
For conditions such as:
specific medical or surgical treatment may be required.
Orgasm Disorders
Treatment may include:
- Sexual education and counseling
- Directed masturbation training
- Pelvic floor therapy
- Treatment of contributing medications or medical conditions
- Sex therapy
No medication is specifically approved solely for female orgasm disorder.
Pelvic Floor Physical Therapy
Often underutilized but very effective for:
- Pelvic pain
- Vaginismus
- Dyspareunia
- Pelvic floor dysfunction
It may involve:
- Muscle relaxation techniques
- Biofeedback
- Stretching and strengthening exercises
Emerging and Investigational Therapies
Some clinics offer:
- Platelet-rich plasma (PRP)
- Energy-based vaginal devices (laser/radiofrequency)
- Shockwave therapy
However, evidence for these treatments remains limited, and major professional societies generally consider them investigational.
Most Effective Overall Approach
For many women, the best outcomes come from combining:
- Identification and treatment of medical causes.
- Management of hormonal issues when present.
- Pelvic floor therapy if pain or muscle dysfunction exists.
- Sex therapy or psychological counseling.
- Relationship-focused interventions when relevant.
Unlike male erectile dysfunction, where a single medication such as Sildenafil may often be effective, treatment of female sexual dysfunction is usually more individualized and often combines several approaches.
