The objective of this presentation is to appreciate what medication changes and additions help which women with hypoactive sexual desire disorder. The biochemistry of female hypoactive sexual desire disorder must be viewed in context of new understanding of female sexual response and new understanding of female \"sex receptors\" or biochemistry of sexual desire. Pharmacodynamics of Dopamine, Serotonin, Prolactin, Nitric Oxide, (Testosterone and Estrogen) will be discussed. Antidepressant, antipsychotic and other medications will be reviewed regarding mechanisms of action and resulting chemical influence on libido. Comparison studies between Paroxetine, Escitalapram and Venlafaxine XR will be presented. Pharmacologic treatment: oral and topical, on and off label for women with low libido will be discussed including use of Bupropion XL, Mirtazapine, Buspirone, Modafinil, 5-phosphodiesterase inhibitors, testosterone, Alprostadil cream, and “Natural Enhancers.\" In conclusion, for sexual desire, women need control and often emotional intimacy as well as enough dopamine, testosterone, estrogen and nitric oxide and not too much prolactin or serotonin 5-HT2 stimulation. This balance can be medically enhanced by choosing medications wisely and deftly, sometimes off-label, as long as benefits outweigh risks.
Conflict of Interest: Advisory Board Of Procter And Gamble, Lilly-Icos National Speaker For The Following Pharmaceutical Companies: Forest, Wyeth, Cephalon
Financial Support/Funding: None disclosed
Sydney, Australia, April 2007
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