What are the recommended pharmacological treatments for female sexual arousal disorder?

Recommended pharmacological treatments for female sexual arousal disorder (FSAD) primarily focus on addressing underlying physiological and hormonal factors, as well as symptom relief. Currently, no UK NICE guidelines specifically endorse a licensed pharmacological treatment solely for FSAD, reflecting the complexity and multifactorial nature of the disorder ¹.

However, emerging evidence and expert consensus from recent literature suggest several pharmacological options that may be considered, particularly in postmenopausal women or those with hormonal deficiencies. These include topical estrogen therapy to improve genital blood flow and tissue health, which can enhance arousal symptoms (Nappi et al., 2022). Additionally, off-label use of testosterone therapy has shown benefit in improving sexual desire and arousal in postmenopausal women with hypoactive sexual desire disorder, which often overlaps with FSAD (Parish and Kling, 2023).

Other pharmacological agents under investigation include phosphodiesterase type 5 inhibitors, which may improve genital blood flow, and centrally acting agents targeting neurotransmitters involved in sexual response, though these are not yet standard treatments (Brotto and Altas, 2024).

In summary, while UK guidelines do not currently recommend specific pharmacological treatments for FSAD, clinical practice informed by recent research supports consideration of hormonal therapies such as topical estrogen and testosterone in selected patients, alongside holistic management.