Stepwise Approach to Treat Sexual Dysfunction in Women


A stepwise approach ensures that all the potential issues and needs affecting a women’s sexual dysfunction are addressed prior to initiating management strategies.

Given the different types of sexual dysfunction in women caused by a host of varying physiological, psychological, and interpersonal components, treatment is anything but straightforward. It requires addressing the specific needs and wants of each patient as well as consideration of both nonpharmaceutical and pharmaceutical options.  

To help clinicians navigate the complexity of treating female sexual dysfunction, Jan L. Shifren, MD, Professor of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, provided a stepwise approach that ensures that all the potential issues and needs affecting a women’s sexual dysfunction are addressed prior to initiating management strategies.1 Table 1 provides a step-by-step description of this approach.1

(Adapted from ref #1)


A number of non-pharmacological options are available to women depending on their needs and preferences. Counseling patients to make lifestyle changes can help them manage stress and address relationship issues, as both stress and conflicts in relationships can significantly adversely affect sexual desire and response in women.1,2 Specific lifestyle changes that may help improve sexual function include healthy diet, regular exercise (including pelvic exercises like Kegels), quitting smokin, avoiding excessive consumption of alcohol, and making time for sex. To increase libido and sexual response, women should be encouraged to add novelty to their relationships through such things as sensual massage, trying different sexual positions or activities, sharing a bath, having sex at different times of the day.1, 2 Some women may need lubricants to avoid painful or uncomfortable intercourse due to vaginal dryness.

For some women, referral to a specialist as discussed above may be the best approach for managing specific issues (Table 2).

Along with these nonpharmaceutical approaches, some women may benefit from various devices or procedures that can improve sexual functioning (Table 3).


1.    Finding Solutions for Female Sexual Dysfunction. American College of Obstetricians and Gynecologists. July, 2010.

2.    Shifren JL. Patient Education: Sexual Problems in Women (Beyond the Basics). UpToDate. 2017.

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