The evaluation of a doctor must always be preliminary to any intervention, just as has been consolidated for the male.

If evaluated correctly with the help of a medical sexologist and gynaecologist, many women can free themselves from sexual problems which, up until today, had marked out an unconfessable destiny without alternatives and which, according to recent estimates, involves a good 30-35% of women in industrialised countries!

A AROUSAL: Arousal is an term that indicates all the modifications in the brain and genitals during female excitation. Today we know that good lubrication is an indispensable start for good sexual relations, depending on good vascularisation as is with the male erection.

A Apomorphone SUB LINGUALE : This is a drug already used for Parkinson's disease: In June, 1998, it was used in a pilot study in the United States; according to the first revelation, the pill is taken before sexual relations, allowing for more blood to enter the female genitalia and improve lubrication.

E Ephedrine : One study alone indicated the possibility of this drug to improve the initial phases of feminine excitation. That is, the drug may be capable of favouring the start of vaginal lubrication and increment a pleasurable sensation.

E Estrogen combined with Testosterone : This is a drug that up until now has been used in the United States only for vasomotor disturbances of menopause. It has been experimented on women in menopause who have lost sexual desire. Then, in 100% of the cases, desire returns and women have started over a new satisfying sexual life.

F Frigidity : This is the equivalence to impotence in the woman. One calculates that one in three women have difficulty in having satisfying sexual relations. Until now, it was believed that this depended above all on mental and psychological causes. Now we know, rather, that frigidity may also be caused by physical reasons - hormonal, muscular and neurological. In the United States, it is estimated that 10 million women have sexual disturbances that can be resolved through medication.

L Libido : It is discovered that the sexual appetite in the woman depends more on testosterone, a male hormone which women have in small quantities, than estrogen, the female hormone par excellence. Therefore, in menopause, one must not only correct the loss of estrogen, but also replace the small dose of testosterone. This is also the case for younger women who lack androgens.

O Oxytocina: For a long time, we have known that this hormone is involved in sexual functioning, in particular, in the orgasmic phase and the sensation of wellbeing that follows. It has come to be used as a nasal spray in Germany! There are no scientific studies on this, however!

P Phentolamine: An early preliminary study shows that the drug has good tolerance and good effects on the sensitivity of the clotoridea and orgasmic capacity when there is a vascular compromise, for example, in diabetic women. It is in the study phase also for the male but the first results in the andrological field make one think that it is not as effective or secure as sildenafil.

P Prostaglandina E1 in cream: This is a vasodilatant that has been used for many years with great success for male erection problems through the use of an injection into the penis. The possibility of using it in cream form for women in menopause to improve the blood flow to the vagina is in the study process.

P Psychology: So now, is psychology no longer useful? It is true that for good sexuality, more is needed than adequate lubrication, correct hormonal placement, etc. But today it is unthinkable that a woman park herself for a long psychological therapy without having first undergone medical, specialist research which could exclude the physical factors or find the right medication. The psychologist must therefore work in strict collaboration with the medical sexologist or gynaecologist, also because the mind always amplifies physical disturbances.

T : Testosterone in Adhesive Patches : As for the male, women can also take a small dose of testosterone through the skin, which avoid engaging the liver. An early experimental study on young women revealed that the surgical removal of the ovaries ("surgical menopause") gives very satisfactory results in returning normal sexual appetite.

T Testosterone in Cream : In the United States, it has become popular following a positive affirmation declared during a televised talk-show with a big listening audience; American gynaecologists prescribe a ointment prepared by pharmacists containing 2-3% testosterone in powder form. This mechanism can contribute to a good saturation of testosterone in the vagina, improving the vascularisation and therefore the lubrication. There are no serious, scientific studies on it, however.

T Oral Therapy for the Woman?: As some biochemical processes of excitation are common to both the male and female, one tries to understand if the same oral therapy applied to the man may be also used for the female. Steven Kaplan of Columbia Presbyterian Hospital in New York has published a study in the prestigious magazine, Urology (N. 53, 3, 1999): only 21% of women treated have attributed advantages to therapy. A great deal of other information is currently present in literature, but should be considered as indefinite, leaving many questions still open. We may reasonably consider that this therapy could find a future opening in applying to women in particular situations.

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