Alleviating the dysfunction

While experts have much to learn about women's sexual problems, they do know of many things that can help.

A variety of drugs, creams, supplements and other means have been found to alleviate female sexual dysfunction, said Barbara Bartlik, of Cornell University's Weill Medical College. And other steps might help, too.

For instance, fatigue and stress are often culprits in sexual dysfunction. Doctors can advise women with problems to consider having sex in the morning, getting more exercise, and taking steps to reduce stress, Bartlik told colleagues this spring at a meeting of the American Psychiatric Association.

Drugs: Various medicines - government-approved for other uses - may enhance sexuality, Bartlik said. These include an antidepressant known generically as trazodone (brand name Desyrel); the antidepressant bupropion (Wellbutrin); and the anti-anxiety drug buspirone (Buspar). Other possibilities include the Parkinson's drugs ropinirole (Requip) and selegiline (Eldepryl).

Because research results haven't been encouraging, drug companies recently decided to stop pursuing government approval for medicines likeViagra, which aids erections in men, as a sexual treatment in women. Bartlik believes that's a mistake.

"It's been estimated that women have as much erectile tissue in their bodies as men do, once you correct for body weight," she said.

Creams and gels: Creams containing prostaglandins, or hormonelike substances, are under development and look promising, Bartlik said. Other topical creams and gels can also be effective, although she worries that those containing menthol might be caustic.

Testosterone patch: Sometimes low levels of the male hormone testosterone can cause sexual dysfunction in women, as well as fatigue and a poorer sense of well-being. Estrogen therapy is one cause of low testosterone levels, Bartlik noted.

A patch, worn on the skin, that emits testosterone is awaiting approval for use in women, she said. Research has found that such a patch can increase frequency of sexual behavior as well as improve mood. "I can't wait until this comes out," Bartlik said.

Supplements: The dietary supplement ArginMax - which contains a mixture of vitamins, minerals and other supplements, many of them linked to better sexual functioning - worked well for women in one placebo-controlled study. By contrast, Avlimil, marketed on late-night TV, has none of the expected "sex-positive" herbs and no published scientific data showing it works, Bartlik said.

Evidence suggests some other supplements may work, such as L-arginine, DHEA, ginseng and yohimbine, she said. But data on others are lacking, and some could cause dangerous side effects. "We need more research in this area," Bartlik said.