For the treatment of FSD in our center we use an integrated approach once psychological issues are being dealt with. We attempt to use bio-identical hormone replacement if indicated replacement of both estradiol and testosterone are key to full sexual stimulation.

We then attempt to use prosexual drugs like Viagra in conjunction with the use of a small amount of testosterone gel alone or compounded with one of the other pharmaceutical described above placed topical over the clitoris. This is usually done 20 minutes prior to the sexual activity. In our practice antidotal evidence reports 6 out of 10 women report more sexual gratification, stronger orgasms and multiple orgasms. We have found that with the systemic replacement of Estradiol and Testosterone in addition to the use of custom compounded topical creams (testosterone/DHT/VIP/phentolamine) applied to the clitoris women whom normally wouldn't be able to experience vaginal orgasm are now able to experience full and pleasurable vagina climax.