Women's Health Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia.
Expert Opin Pharmacother. 2012 Oct;13(15):2131-42. doi: 10.1517/14656566.2012.725046.
Female sexual dysfunction (FSD) is a global health issue, with as many as 12% of women over 18 years old reporting sexual difficulties associated with distress. It is a multifaceted problem with psychological and biological causes. Affected women tend to have an impaired quality of life, a decreased level of well-being and relationship issues. Hence there is a need for management options for affected women.
This paper focuses on current pharmacological options for the treatment of FSD, particularly estrogens and androgens, which have been extensively studied. Some investigational drugs are also described, including the centrally acting agents such as flibanserin and bupropion, and intravaginal DHEA and testosterone, which may be useful as an alternative for women with specific conditions, such as breast cancer survivors.
Although approval for the use of testosterone for treatment of FSD is limited to some European countries and restricted to surgically menopausal women, there is extensive off-label use for this purpose. No other product has yet achieved regulatory approval for treatment of FSD. Completion of studies of nonhormonal FSD therapies and safety studies of testosterone may result in regulatory approval of such products for the treatment of FSD in the near future.
女性性功能障碍(FSD)是一个全球性的健康问题,多达 12%的 18 岁以上女性报告存在与痛苦相关的性困难。这是一个多方面的问题,有心理和生理原因。受影响的女性往往生活质量受损,幸福感降低,且存在关系问题。因此,需要为受影响的女性提供管理选择。
本文重点介绍了治疗 FSD 的当前药理学选择,特别是雌激素和雄激素,这些药物已经得到了广泛的研究。还描述了一些研究中的药物,包括中枢作用药物,如氟班色林和安非他酮,以及阴道内 DHEA 和睾酮,它们可能对某些特定条件的女性(如乳腺癌幸存者)有用,可作为替代选择。
尽管睾酮用于治疗 FSD 的批准仅限于一些欧洲国家,且仅限于手术绝经后的女性,但出于这一目的,睾酮的使用存在广泛的超适应证情况。目前尚无其他产品获得治疗 FSD 的监管批准。非激素 FSD 治疗研究的完成和睾酮的安全性研究可能会导致这些产品在不久的将来获得监管批准,用于治疗 FSD。