The complexities of female sexual arousal disorder: potential role of pharmacotherapy

Identifying any role for pharmacotherapy in women's sexual arousal disorders requires an understanding of the components of sexual arousal. Furthermore, an analysis of female sexual arousal disorders necessitates distinguishing between the absence of physiological genital responding and lack of attention to, or dislike of, any physiological responding. Pharmacologically enhancing a suboptimal physiological vasocongestive response is possible. Current studies involve both medications that magnify the affects of a natural neurotransmitter of genital sexual arousal (nitric oxide), and those that act independently of the natural mechanism. Enhancing attention to genital engorgement by pharmacological means is at present theoretical. Similarly, non-hormonal pharmacological means of facilitating pleasure from the arousal-associated genital congestion awaits scientific study. When a deficiency of estrogen or androgen is involved in the lack of pleasure from massaging vulval structures and/ or involved in their suboptimal engorgement, their replacement can be beneficial. Scientific study of physiological androgen replacement therapy is only just beginning.