Improving the Recognition, Assessment, and Treatment of Female Sexual Dysfunction
During a session at the 2023 French Urology Association conference, Charlotte Methorst, MD, a urologist from Paris, and Carol Burté, MD, a sexologist and andrologist from Nice, addressed the need for doctors to be involved in women’s sexual health.
Methorst pointed out that there is currently a significant disparity in the discussions of sexual health within the medical community. Patients are willing to discuss sexual health matters, especially women, yet doctors seldom broach the topic. Recognizing sexual dysfunction is crucial as patients rarely bring up the issue (19%), and healthcare providers even less (9%), despite it being a prevalent problem (40%). These dysfunctions can greatly impact a couple’s life and relationship, and may also reveal underlying conditions, Burté added.
In terms of recognizing the condition, Methorst and Burté highlighted the importance of utilizing the self-administered Female Sexual Function Index, which covers six areas of sexual dysfunction: desire, subjective arousal, lubrication, orgasm, satisfaction, and pain or discomfort. They also suggested the use of the Sexual Complaints Screener, which evaluates a woman’s sexual health over the past 6 months.
Understanding the root cause of sexual dysfunction is essential, and it involves examining the patient’s medical and sexual history using a biopsychosocial approach. Once the triggering factors are identified, tailored therapy approaches can be discussed with the patient.
In some cases, lifestyle changes and counseling can help improve sexual dysfunction, while sexual therapy and medication may be required in other instances. An integrative approach is often necessary due to the multifactorial nature of women’s sexual dysfunction.
The use of cognitive behavioral therapy (CBT) and certain medications were highlighted as primary therapy options for sexual dysfunction. However, Vasoactive drugs have resulted in disappointing outcomes, while central nervous system-acting medications have not been approved in France due to their „inadequate“ risk-benefit ratio. Nonetheless, topical hormones are commonly used and have been found to be effective, particularly in postmenopausal women.
Testosterone, while not yet approved in France, was identified as a possible treatment for postmenopausal women, based on international consensus and recommendations from the International Society for the Study of Women’s Sexual Health.
Methorst and Burté emphasized the importance of collaborating with other healthcare professionals and specialists in sexual health.
This content is based on a translation from the French edition of Medscape. Charlotte Methorst, MD, reported relationships with several pharmaceutical companies, while Carol Burté, MD, declared no conflicts of interest regarding the content of this article.