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Abstract:

Steroid hormones affect the sexual response in women. Estrogens are pivotal for genital vasocongestion and lubrication, i.e. arousal. The menopausal transition is accompanied by a deterioration of several parameters of the sexual response, although this effect appears to be smaller than the influence of age and general health. Estrogen therapy should be considered for postmenopausal women with disturbed arousal; topical application of low-dose estrogen preparations may have advantages over systemic therapy. In estrogen-treated women with persistent hypoactive sexual desire, low-dose androgen treatment may be considered; and testosterone preparations appear to be more effective than dehydroepiandrosterone. Tibolone, available in European countries, exerts both estrogenic and androgenic effects, and probably has a beneficial effects/side-effects profile in postmenopausal women with sexual response dysfunction. Non-hormonal approaches include the use of sildenafil citrate; but typical use of the latter preparation does not appear to improve the sexual response in postmenopausal women.