The Effects of Herbal Medicines on Women Sexual Dysfunction: A Systematic Review

: Sexual health plays an important role in the women’s health and quality of life. Sexual health management is a prerequisite for physical and psychological health of women. Sexual desire, arousal, and orgasm are three factors of female sexual response. So far many different methods has been known for the treatment of female sexual dysfunction, however none of them are not an efficacious therapy. Generally, use of herbal medicine is a safe and effective therapeutic method in the treatment of women with sexual dysfunction. The role of herbal and nutritional supplementation in female sexual function has attracted researchers’ interest in recent years. This study aimed to the evaluation of the studies focusing on the herbal medicine on women sexual function and the assessment of its effectiveness.

The influence of Mat Pilates associated with perineal contraction in the female sexual response

Background: The Pilates Method is a program of physical and mental training that involves the whole body, aiming at the gain of muscular strength, mainly of the central region, formed by the abdominal muscles, the spine and the pelvic floor muscles (PFM). The PFM responds to sexual stimulation, with increased local blood circulation and involuntary contractions during orgasm. The training of this musculature assists in the female sexual function. Objective: To evaluate the influence of Pilates Mat associated with perineal contraction in the female sexual response. Method: Uncontrolled clinical trial in which participated twelve women between 20 and 50 years old, who performed Mat Pilates classes associated with perineal exercises, three times a week. The sexual response was evaluated through the Female Sexual Function Index (FSFI) and the contraction capacity of PFM through the Functional Evaluation of the Pelvic Floor (FEPF) before and after 21 sessions. Results: Given the proposed treatment, the FSFI responded positively (0.0099), with an improvement in the median and interquartile range that initially was 25.6 ± 5.4 and increased to 28.4 ± 1.2. The Functional Evaluation of the Pelvic Floor (FEPF) also achieved significant improvement (p= 0.0077), increased from the initial median and interquartile range of 2 ± 1.5 to 4 ± 1. Conclusion: Mat Pilates provides encouraging results, and its use is relevant to promote improved sexual response and strength gain of the pelvic floor muscle.

Female Sexuality: Assessing Satisfaction and Addressing Problems

Sexuality is important to women of all ages. Although changes in sexual function occur with aging, hormonal transitions, illness, the use of medications, and disability, many women can maintain a satisfying sex life by making appropriate adaptations. Clinicians who take the time to obtain a complete and careful sexual history and perform a pertinent physical examination can help the majority of women who present with sexual complaints. Effective treatment must address the contribution of psychological, relationship, and biologic factors and often requires the collaboration of physicians and psychotherapists, as well as sex and physical therapists in many circumstances. Simply initiating a discussion about sexual concerns is frequently the most valuable aspect of treatment for women and their partners. Also useful are provision of basic education about normal female genital anatomy and sexual function across the lifespan; permission to explore masturbation, erotica, and versatile sexual techniques, as well as nongenital pleasuring; information about lubricants; and the prescription of estrogen in the setting of vulvovaginal atrophy. There are as yet no approved agents to treat the biologic component of hypoactive sexual desire. However, it may be appropriate to consider using androgen supplementation in patients with surgical menopause, as well as the addition of bupropion in patients taking selective serotonin reuptake inhibitors (SSRIs). This review discusses the epidemiology of female sexual disorders, the female sexual response and sexual behavior, and the diagnosis and management of specific sexual disorders, including desire, arousal, orgasm, and sexual-pain problems. This review contains 4 figures, 41 tables, and 96 references. Keywords: Sexual dysfunction disorder, arousal, orgasm, desire, dyspareunia, vulvodynia, vestibulitis, vaginismus

Female Sexuality: Assessing Satisfaction and Addressing Problems

Sexuality is important to women of all ages. Although changes in sexual function occur with aging, hormonal transitions, illness, the use of medications, and disability, many women can maintain a satisfying sex life by making appropriate adaptations. Clinicians who take the time to obtain a complete and careful sexual history and perform a pertinent physical examination can help the majority of women who present with sexual complaints. Effective treatment must address the contribution of psychological, relationship, and biologic factors and often requires the collaboration of physicians and psychotherapists, as well as sex and physical therapists in many circumstances. Simply initiating a discussion about sexual concerns is frequently the most valuable aspect of treatment for women and their partners. Also useful are provision of basic education about normal female genital anatomy and sexual function across the lifespan; permission to explore masturbation, erotica, and versatile sexual techniques, as well as nongenital pleasuring; information about lubricants; and the prescription of estrogen in the setting of vulvovaginal atrophy. There are as yet no approved agents to treat the biologic component of hypoactive sexual desire. However, it may be appropriate to consider using androgen supplementation in patients with surgical menopause, as well as the addition of bupropion in patients taking selective serotonin reuptake inhibitors (SSRIs). This review discusses the epidemiology of female sexual disorders, the female sexual response and sexual behavior, and the diagnosis and management of specific sexual disorders, including desire, arousal, orgasm, and sexual-pain problems. This review contains 4 figures, 41 tables, and 96 references. Keywords: Sexual dysfunction disorder, arousal, orgasm, desire, dyspareunia, vulvodynia, vestibulitis, vaginismus

Anatomical Dissection of the Dorsal Nerve of the Clitoris

Background The clitoris is the primary somatosensory organ of female sexual response. Knowledge of its neural anatomy and related landmarks is essential for safe genital surgery. Objectives The aim of this study was to describe the distal course of the dorsal nerves of the clitoris and associated structures. Methods Clitorises of 10 fresh cadavers were dissected. Measurements of the dorsal nerves, suspensory ligament, clitoral body, clitoral hood, and clitoral glans were obtained. The course of the dorsal nerves was examined. Results The dorsal nerves of the clitoris were larger than expected, ranging from 2.0 to 3.2 mm in diameter, on average, along their course in the clitoral body. In 9 of 10 specimens, the dorsal nerves could be traced to within 6 mm of the glans. They traveled deep to a superficial clitoral fascia but superficial to the tunica albuginea, were variably located between 10 and 2 o’clock, and were separated by the deep suspensory ligament (DSL) of the clitoris. The mean length of the descending clitoral body, from the angle to the base of the glans, was 37.0 mm. The mean distance from the pubic rim to the DSL was 37.7 mm. Conclusions The clitoral body is substantial in length, mostly lying superficially under the clitoral hood and mons pubis. The dorsal nerves of the clitoris are large and superficial, terminating at or near the base of the clitoral glans. Knowledge of this anatomy is critical prior to performing surgery near the clitoris.

Uroneurology

The function of the pelvic organs, including the lower urinary tract (LUT), is controlled by a complex network of nerves. This leaves patients with neurologic disease vulnerable to LUT and pelvic organ dysfunction. Physicians often come across urogenital complaints in their patients with neurologic disease, the symptoms of which can result in significant distress and loss of dignity and quality of life. Due to the health and economic burden that accompanies neurogenic pelvic organ dysfunction, it is important for clinicians to understand the common forms of dysfunction, essential investigations, and modes of management. This chapter covers bladder dysfunction from a physician’s perspective. Topics include neurologic control of the LUT, large bowel, and sexual functions; male and female sexual response; neurogenic bladder dysfunction and its management; diagnostic evaluation; management of neurogenic sexual dysfunction; management of erectile dysfunction; ejaculatory dysfunction; sexual dysfunction in women; and fecal incontinence. Figures illustrate efferent innervation of the LUT, neurologic detrusor overactivity, a urethral pressure profile in a patient with Fowler syndrome, an example bladder diary, an example bladder scan, and normal and obstructed flow patterns. Tables list common causes of injury at the suprapontine, suprasacral, and infrasacral levels and storage and voiding systems. This chapter contains 6 highly rendered figures, 2 tables, 53 references, 1 teaching slide set, and 5 MCQs.