Female sexuality

Female sexuality is an extraordinarily complex process. The physician needs to be aware of the patient's sexuality and whether or not there are sexual concerns. Physiologic changes over the lifespan can interact with sexual performance as can a variety of disease processes. Partner and relationship issues must also be taken into account. Physicians need to include a sexual history as part of their general history and should not be judgmental of their patients' sexual practices. Sexual disorders in women are defined and delineated by those issues causing personal distress. Again, one person's distress may be quite normal to another. The important aspects of care consist of listening, educating, and providing support to the patient. There is increasing interest but a continued need for data in the use of testosterone in women with decreased libido. The use of sildenafil for female sexual dysfunction remains controversial as a benefit. Overall, there is a need for the development of well-organized, randomized, controlled studies on appropriate assessment and intervention for sexual dysfunction in women.