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Treatment
Below is a look at what is currently known about treatment options for the DSM-IV diagnoses of sexual and arousal disorders as well as recommendations for future investigations should SIAD be the new diagnosis. It should be noted that this is what is known when looking at arousal, desire, and orgasm separately however there is a lot of overlap within treatment options. When SIAD is entered into the DSM-V the treatment research will likely transfer over to treatment options specific to that diagnosis criteria, until then, however, below is a review of the current understanding.

General Treatments Relevant to All Sexual Problems in Women
Also see sexual dysfunction. There are some general changes to lifestyle that can impact all sexual function and disorders. Improved well being including diet, exercise, possible alcohol and chemical substance abuse, and sleep should be addressed in all women. Prescription and nonprescription medications, vitamins and herbal supplements and recreational drugs can also impact sexual function. Finally, education about basic genital anatomy and physiology, and a discussion of sexual stimulation and sexual activities other than intercourse should be part of early stage treatment as well as learning to use techniques that enhance arousal.

Treatment Issues Specific to Low Desire
For more information specific to desire disorders, see hypoactive sexual desire disorder

Psychosexual Treatments for Low Desire
There are only a few studies looking at treatments that focus specifically on low desire. However, in treatment, when low desire is accounted for by depression, poor body image, sexual assault, or other factors, these factors must be addressed first. Some psychosexual treatments that have shown to impact desire have been group cognitive behavioral therapy treatments, a modified Masters and Johnson sex therapy , and sensate focus and traditional sex therapy techniques. In one non-controlled trial, mindfulness-based cognitive therapy administered in a group format to women with mixed HSDD and FSAD resulted in significant improvements in sexual desire and other domains or sexual response and mood.

Recommendation
Psychological approaches have a long history of being effective immediately after treatment and sustained, as well as not having any adverse side effects. . Newer cognitive-behavioural treatments which integrate mindfulness meditation show excellent promise but require controlled testing  so this may be worth investing in. In general more randomized, controlled testing is required in order to make more conclusive inferences about these treatments.

Hormonal Treatments for Low Desire
Testosterone (T) has been used for hormonal treatment since the 1930s. In more recent controlled studies 300μg/day patch increased sexual desire, , ,. However, in one study 30% of T group experienced androgenic side effects and there were four new cases of breast cancer in the T but not the placebo group. In Europe, Tibolone (an androgenic, progestogenic, and estrogenic synthetic hormone) is available and has shown a significant increase in Female Sexual Function Index (FSFI) after 24 weeks of use. It has also been shown to significantly increase sexual desire, arousability, vaginal lubrication, and the frequency of sexual fantasies compared to a placebo condition.

Recommendation
T therapy is effective for estrogen-replete, naturally menopausal women and marginally effective for pre-menopausal women however there is conflicting data showing no effect among cancer survivors with HSDD. The long-term risks are unknown for breast cancer, insulin resistance, and metabolic syndromes so careful discussion of risks is necessary before using this treatment method.

Nonhormonal Medications for Low Desire
In non-depressed women with HSDD, the anti-depressant Bupropion was found to significantly improve sexual arousal and orgasm but not sexual desire. . As well it is seen to benefit both males and females. Flibanserin is a centrally acting agent for HSDD however the method of action is not fully understood. It is suggested to act on a 5-HT2A serotonin receptor agonist and 5-HT1A serotonin receptor antagonist. A pooled analysis of 1378 premenopausal US women showed a statistically significant increase in the frequency of sexually satisfying events in women taking Flibanserin. However, in 2010 the FDA did not approve of the drug stating that the results were not robust enough to justify the risks.

Recommendation
These medications do show promise but randomized controlled trials are required.

Treatment Issues Specific to Low Arousal
For more information specific to arousal disorders, see female sexual arousal disorder

Psychological Treatments
Generally sensate focus and masturbation training are used as psychological treatment for low arousal, and tends to emphasize self-focus and assertiveness. However, there have not been any randomized control trial studies for psychological treatment of FSAD.

Recommendation
Psychological treatment should be recommended for FSAD because the majority of sexual arousal problems in healthy women are not due to impaired genital responsiveness.

Hormonal Pharmacotherapy for FSAD
In a placebo controlled study with hypogonadotropic hypogonadal women or those suffering from hypogonadism, treatment with testosterone undecanoate enhanced genital arousal . Local and systemic estrogen treatment benefits vulvo-vagnial atrophy and relieves vaginal dryness and dyspareunia . .  As well [[Tibolone has been used as treatment in postmenopausal women in a randomized, double-blind, cross-over study and showed a significant increase in vaginal blood flow in response to erotic fantasy .  This is associated with a significant increase in sexual desire, frequency of arousability and of sexual fantasies compared with those taking a placebo  .  Vaginal lubrication was significantly improved as well.

A randomized controlled trial studying the effect of vaginal application of dehydroepiandrosterone (DHEA) on vaginal atrophy in postmenopausal women showed rapid beneficial change to vaginal epithelial cell maturation and vaginal pH as well as increase sexual desire/interest, sexual arousal, orgasm, and pain.

Nonhormonal Pharmacotherapy for FSAD
For men, there has been the development of many pharmacological treatments in order to treat arousal disorders and many pharmacological treatments have been tested in women, however none have been approved for use for women.

Treatment Issues Specific to Difficulties with Orgasm
For more information specific to orgasmic disorders, see female orgasmic disorder. There is some evidence that shows significant heritability in orgasmic function both alone or with a partner. Directed masturbation, sex education, anxiety reduction techniques, and CBT remain the main therapeutic tools for anorgasmia. However, sildenafil used for women with SSRI-induced FOD showed to have significantly fewer negative sexual side effects.

The Placebo Response
For more information specific to placebo response, see placebo. With all of these treatments, there is significant placebo response among women randomized to the placebo group of a drug trial, , ,. Bradford and Meston reviewed 16 placebo-controlled pharmacological trials in women’s sexual dysfunction and found that placebo response is stronger in retrospective studies, those studies using postmenopausal women, and those focusing on sexual desire. .

Overall Recommendations For SIAD Treatment
Some of the issues with the current research on treatment for female desire and arousal disorders are that few studies have looked at arousal and sexuality from a cultural perspective and thus these disorders are observed through an ethnocentric lens, sexual stimulation must be assessed, studies with better methodological trials on psychological treatments are needed, and subjective excitement, pleasure, and relationship satisfaction should be targeted end points in all future randomized control trials.