University Hospitals program treating women's sexual dysfunction

CLEVELAND, Ohio -- Twelve years ago, the Food and Drug Administration approved Viagra for men with erectile-dysfunction issues.

In April, Stendra (generic name: avanafil) became the fourth drug to receive FDA approval for the problem. It is poised to join Viagra, Cialis and Levitra as the latest in a class of drugs called PDE5 inhibitors. Designed to be taken on an "as needed basis 30 minutes before sexual activity," according to the FDA, Stendra has a faster onset than its predecessors.

For women with sexual-dysfunction issues, the wait continues for any FDA-approved drug.

Sexual dysfunction in women is not as cut-and-dried as it is in men. Low libido -- hypoactive sexual desire disorder in clinical terms, or HSDD -- is the most common sexual disorder in women.

But vulvodynia (chronic pain in the vulva, the area that contains a woman's outer sexual organs), anorgasmia (inability to reach orgasm), vaginismus (an involuntary spasm of the muscles surrounding the vagina) and dyspareunia (persistent or recurring pain in the genital region before, during or after sex) all fall in the "sexual disorder" category.

Statistics are hard to come by, but HSDD and other sexual disorders tend to increase in prevalence as a woman ages and reaches menopause. Published studies put the prevalence of anorgasmia between 10 percent and 20 percent.

In focusing on treating these disorders, a new division at University Hospitals MacDonald Women's Hospital is part of a small but growing trend of care that a generation ago was barely discussed in public.

Sheryl Kingsberg, a women's health psychologist specializing in female sexual dysfunction, and Dr. Roya Rezaee, an OB-GYN specializing in sexual medicine (she is the designated vulvar and sexual-dysfunction specialist at UH), are co-directors of the new Division of Sexual Function and Vulvovaginal Health.

Until the division's creation in late 2011, the sexual-medicine program at MacDonald Women's Hospital was composed solely of Kingsberg, who also serves as chief of UH's Behavioral Medicine Program and who consulted regularly with UH physicians. When Rezaee joined the hospital in January 2010, the two began collaborating.

"The patients [Kingsberg] sees first are those with emotional distress and dysfunction that their [physician] doesn't think is an anatomical issue," Rezaee said. "I get the ones who know they have pain, who know they have hormonal issues. The physical and emotional go hand in hand."

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University Hospitals program treating women's sexual dysfunction