Editing Sexual dysfunction (section)

===Females===
In 2015, [[flibanserin]] was approved in the US to treat decreased sexual desire in women. While it is effective for some women, it has been criticized for its limited efficacy, and has many warnings and contraindications that limit its use.<ref>{{cite web|url=https://www.webmd.com/women/news/20150818/fda-approves-addyi-drug-boost-womens-sex-drive#1|title=FDA Approves First Drug to Boost Women's Sex Drive|website=www.webmd.com|access-date=2019-05-31}}</ref> Flibanserin was found to increase pleasurable sexual experiences by 0.5 events per month in trials. Possible side effects include dizziness, drowsiness, nausea and fatigue.<ref name="Davis 2024" /> Flibanserin should not be taken with alcohol.<ref name="Davis 2024" /> [[Bremelanotide]] has been shown to modestly increase sexual desire in women, but it has not shown evidence of increasing the number of satisfactory sexual experiences per month. Possible side effects include nausea, flushing and headaches.<ref name="Davis 2024" /> Women experiencing pain with intercourse are often prescribed pain relievers or desensitizing agents; others are prescribed [[personal lubricant|vaginal lubricants]]. Many women with sexual dysfunction are also referred to a [[mental health counselor|counselor]] or [[sex therapy|sex therapist]].<ref name=Amato>{{cite web | vauthors = Amato P | title = An update on therapeutic approaches to female sexual dysfunction | url = http://www.femalesexualdysfunctiononline.org/commentaries/commentaries.cfm?abs_id%3Dabs_007 | work = Female Sexual Dysfunction Online &#124; A Blog to Document the High's and Low's of My Life |access-date=2008-10-24 |url-status=dead |archive-url=https://web.archive.org/web/20081004092107/http://www.femalesexualdysfunctiononline.org/commentaries/commentaries.cfm?abs_id=abs_007 |archive-date=2008-10-04 }}</ref> Counselling for female sexual dysfunction, including [[sex therapy|sexual counselling]], [[cognitive behavioral therapy]], body awareness counselling, and [[couples counselling]] have been found to be helpful.<ref name="Davis 2024" />

Estrogen replacement therapy, outside of the indicated use for menopausal symptoms, is not recommended for the treatment of sexual dysfunction in women.<ref name="Davis 2024" />

====Menopause====
Estrogens are responsible for the maintenance of collagen, elastic fibers, and vasculature of the urogenital tract, all of which are important in maintaining vaginal structure and functional integrity; they are also important for maintaining vaginal pH and moisture levels, both of which help to keep the tissues lubricated and protected.<ref name="eden" /> Prolonged estrogen deficiency leads to atrophy, fibrosis, and reduced blood flow to the urogenital tract, which cause menopausal symptoms such as vaginal dryness and pain related to sexual activity and/or intercourse.<ref name="eden" /> Women experiencing vaginal dryness who cannot use commercial lubricants may be able to use coconut oil as an alternative.<ref>{{Cite journal |last1=Evangelista |first1=Mara Therese Padilla |last2=Abad-Casintahan |first2=Flordeliz |last3=Lopez-Villafuerte |first3=Lillian |date=January 2014 |title=The effect of topical virgin coconut oil on SCORAD index, transepidermal water loss, and skin capacitance in mild to moderate pediatric atopic dermatitis: a randomized, double-blind, clinical trial |journal=International Journal of Dermatology |language=en |volume=53 |issue=1 |pages=100–108 |doi=10.1111/ijd.12339|pmid=24320105 |doi-access=free }}</ref>

Androgen therapy for hypoactive sexual desire disorder has a small benefit but its safety is not known.<ref name=Wri2015/> It is not approved as a treatment in the United States.<ref name=Wri2015>{{cite journal | vauthors = Wright JJ, O'Connor KM | title = Female sexual dysfunction | journal = The Medical Clinics of North America | volume = 99 | issue = 3 | pages = 607–628 | date = May 2015 | pmid = 25841603 | doi = 10.1016/j.mcna.2015.01.011 }}</ref> It is more commonly used among women who have had an oophorectomy or are in a postmenopausal state. However, like most treatments, this is also controversial. One study found that after a 24-week trial, women taking androgens had higher scores of sexual desire compared to a placebo group.<ref name="eden" /> As with all pharmacological drugs, there are side effects in using androgens, which include [[hirsutism]], acne, [[Polycythemia|polycythaemia]], increased high-density lipoproteins, cardiovascular risks, and [[endometrial hyperplasia]].<ref name="eden" /> Alternative treatments include topical estrogen creams and gels that can be applied to the vulva or vagina area to treat vaginal dryness and atrophy.<ref name="eden" />