Sexual Dysfunction

One out of every ten premenopausal women experiences sexual dysfunction, yet fewer than 50% of healthcare providers address these concerns. Various forms of sexual dysfunction can affect women, including Hypoactive Sexual Desire Disorder (HSDD), Female Arousal Disorder (FAD), and Dyspareunia.

Hypoactive Sexual Desire Disorder (HSDD)

Signs of HSDD:

Reduced or absent interest in sexual activity.

Distress and frustration due to the lack of desire.

Lack of sexual fantasies or thoughts.

Persistent and distressing decline in sexual desire

Avoidance of sexual activity.

Arousal Disorder

Arousal Disorder is characterized by the persistent or recurring inability to achieve sexual arousal or maintain it throughout sexual activity. In women, this may manifest as difficulty becoming adequately lubricated during foreplay and intercourse, as well as a lack of pleasure from sexual intercourse.

Several health conditions can contribute to decreased arousal, including:

Peripheral Vascular Disease



Pelvic Floor Dysfunction


Previous Negative Experiences or Feelings Toward Intercourse.

Neurological or Spinal Issues

Seeking guidance from a healthcare provider can help address the underlying causes and explore appropriate treatments for Arousal Disorder.


Is sexual intercourse causing discomfort or pain?

You may be experiencing Dyspareunia. This is a medical condition for recurrent genital pain caused by sexual activity. Dyspareunia can have a significant effect on physical and mental health, as well as quality of life.

Possible contributors to pelvic pain include:

Reduced or absent interest in sexual activity.

Distress and frustration due to the lack of desire.

Lack of sexual fantasies or thoughts.

Persistent and distressing decline in sexual desire

Avoidance of sexual activity.


Medical treatment options for sexual and pelvic pain issues include oral tricyclic antidepressants, oral or topical hormonal replacement, oral NSAIDs, cognitive behavioral therapy, and other therapies. Treatment of Dyspareunia depends on the underlying condition.
At Optimal Body, we will order necessary studies and applicable treatments to help restore pleasure without pain.



The treatment for HSDD typically involves a combination of medical, psychological, and lifestyle interventions. Our healthcare providers will work closely with you to determine the most appropriate treatment plan tailored to your needs.

Here are some common approaches:

Counseling or Therapy: Psychotherapy, such as cognitive-behavioral therapy (CBT) or sex therapy, can help address any underlying psychological factors contributing to HSDD.

Hormone Therapy: In some cases, hormone therapy may be considered. This can involve using testosterone, often in the form of a topical gel or patch, to boost sexual desire.

Medications: There are medications approved by the U.S. Food and Drug Administration (FDA) specifically for the treatment of HSDD in premenopausal women. These medications, such as Addy, aim to enhance sexual desire and may be prescribed by a healthcare provider after a thorough evaluation.

Lifestyle Changes: Lifestyle modifications can also play a role in managing HSDD. These include addressing stress, improving overall health through exercise and a balanced diet, and optimizing sleep patterns.

While there are currently no FDA-approved treatments designated explicitly for arousal disorder in women, several off-label options have demonstrated effectiveness.

These include:

Bupropion and Buspirone: These medications have been used off-label to address sexual dysfunction independently.

Sildenafil/Tadalafil: Some studies have indicated that these medications can enhance clitoral blood flow, similar to their effects in men with erectile dysfunction. However, they may not significantly improve sexual desire.

Micronized Testosterone Cream: Applied to the clitoris or skin, this treatment may be considered for individuals with low libido after addressing estradiol deficiency.

Scream Cream: This topical treatment contains Aminophylline, L-Arginine, and Sildenafil, alone or compounded with Testosterone or DHEA.

Non-Pharmacological Approaches: Non-pharmacological strategies can also be practical and evidence-based.

These include using sexual aids, clitoral stimulation, clitoral pumps, engaging in intimate communication with one's partner, talking openly about desires, and exploring digital intimacy through sexting.

Individuals may experience sexual disorders differently. If you have concerns about arousal, consult our healthcare provider for personalized treatment recommendations.