Sexual Dysfunction in Women

A 54-year-old woman presents with low libido, diminished arousal, and anorgasmia. She had undergone a hysterectomy and bilateral salpingo-oophorectomy at 49 years of age owing to menorrhagia and a family history of ovarian cancer. She has been using transdermal estradiol patches and topical vaginal estradiol and has no menopausal symptoms or dyspareunia. She is in a loving relationship with no major life stressors, does not have depression, and takes no other medication. All other clinical characteristics, including her weight and blood pressure, are normal. She has recently become aware that there may be treatment options for low libido and would like to discuss these with you.