Several success have been achieved through initiating testosterone therapy, off-label use of Viagra®[1] and the over the counter use of DHEA-S.  These medications include complications of their own. Long term use of testosterone causes unwanted facial hair growth and virilization in women, and Viagra as well as DHEA-S can cause heart complications and headaches. These are issues best discussed with your physician based on your holistic approach.

Sexual Arousal Disorder
 

So you can pass the first stage, but you’re having trouble “getting turned on”. The most frequent complaints in this phase include decreased vaginal lubrication, swelling, or other responses such as nipple sensitivity.

What are the causes of these problems?

Although the causes can still be emotional in origin, such as depression, there are numerous medical factors that have been recently studied which may attribute to arousal disorders. It is important to keep in mind that physiologic responsiveness to sexual desire is vitally connected to sexual desire, because the inability to enjoy the arousal of sexual stimulation will lead to decreased interest and desire.

Medical:

As before, interactions with medications must be initially ruled out.

1. Circulatory problems including diabetes, elevated blood pressure and heart disease have been notorious for causing erectile dysfunction in men, and are increasingly seen as a culprit for the erectile dysfunction in women. The reduced blood flow leads to decrease clitoral and vaginal blood flow leading to decreased sensation and arousal. This is also the reason high cholesterol and smoking, which also elevate blood pressure and compromise circulation, lead to erectile dysfunction. Put simply, the cleaner the pipes that head south are, the better the pump will function.

2. Hormonal deficiencies that drop off, particularly with estrogen, are significantly responsible for the complaints of vaginal dryness and itching that make arousal difficult.

3. Nervous system disorders, such as stroke, spinal cord injuries, and diseases such as multiple sclerosis are all responsible for controlling the nervous system, which is critical for transporting sensory impulses to the brain and the body.

However, this is also frequently the case for women undergoing breast augmentation. All too frequently, women who have implants placed through the nipple will complain of diminished breast and nipple sensation since the sensory nerves around the nipple have been damaged during the procedure. TOP

What are the current treatments for arousal
 disorders?

Correction of any of the medical or surgical complications mentioned above need to be attended to first.  TOP

1. Estrogen creams and gels are highly effective in cases where postmenopausal or hormone deficiency has caused vaginal atrophy and dryness. Keep in mind, that many times estrogen alone will decrease testosterone, so it may be wise to have a balance of both hormones, since they are teamed up together for the desire-arousal cycle.

2. Sildanefil, or Viagra, is being sometimes utilized for off-label uses in treating sexual dysfunction and arousal problems in women. One of the most common settings that it may be used is adjunctively with an SSRI antidepressant to alleviate the sexual complications they often produce. There are current studies underway to develop a form of this drug for female sexual dysfunction.

3. Hormone Replacement Therapy:  In the postmenopausal or surgically menopausal women, low dose, short-term usage of estrogen may be an effective treatment. Keep in mind, that estrogen must be given with progesterone to protect from endometriosis or endometrial cancers. (Assuming an intact uterus, of course). Acceptable alternatives to synthetic estrogen are natural plant and herbal sources, especially from soy products, legumes and flaxseed oil. Soy has an additive effect in promoting sexual health because it has been shown to decrease cholesterol and heart disease. (See “Joy of Soy”) Numerous studies both here and abroad are showing that acupuncture, and Chinese herbs such as black cohosh and dang gui help promote menstrual function. (See herbal dictionary for more info).  TOP

Orgasmic Disorder

Whether you’ve never achieved orgasm (primary orgasmic disorder) or have lost the ability to reach one (secondary orgasmic disorder), it is personal distress and concern to the woman that will bring her to seek attention. As with the prior two examples, the causes can stem from emotional causes such as relationship discord or medical problems such as drug side effects and surgical complications. A full medical workup to determine if any of these problems exist need to be attended to first before any other advanced therapies or treatments are utilized. For a list of medical problems that cause either arousal or orgasmic difficulties, see the comprehensive examples above.  TOP

Painful Intercourse

Medically known as dyspareunia, there are many common medical conditions that could be responsible for pelvic and vaginal pain. Infections of any sort, to uterine conditions such as endometriosis and fibroids, trauma from episiotomy, and of course hormonal deficiencies causing vaginal dryness and atrophy are all common causes of painful intercourse. Most of these conditions are all easily diagnosed and treated by your health care provider. Treatment will usually be directed either towards the cause (if traumatic), or estrogen creams and gels if dryness and atrophy are the culprits. TOP

Here, as always, it is important to consider psychogenic causes of pain. Often, traumatic sexual experiences can manifest as painful sensations, and cases such as these do require psychotherapy.

Enhancing your Sexual IQ:

 We are at an exciting time when one of the most complex and beautiful aspects of our humanity is being studied and explored. Without a doubt, sexuality as a clinical field will undergo many changes and answer many questions, as well generate many more. Yet, by staying on top of what the new studies and research shows, the effort and time you put into learning more about the causes of sexual dysfunction and its solutions will be a worthwhile investment that your children will surely appreciate!

• Optimizing Fertility

• Male Infertility

• Causes of Sexual Dysfunction

• Treatment of Sexual Dysfunction

• 8 Steps to Heightened SEXUAL
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