Randomized controlled trials of pharmacologic agents for the treatment of female sexual dysfunction (FSD) have typically shown significant placebo responses. In a recent meta-analysis, researchers have assessed the magnitude of this effect. The analysis was restricted to randomized, controlled trials which used the Female Sexual Function Index to assess sexual functioning.
Eight studies were included in the analysis; a total of 2,236 patients received active treatment and 1,723 patients received placebo. Pharmacologic interventions included flibanserin (Addyi), bupropion, onabotulinum toxin A, intravaginal prasterone, intranasal oxytocin, ospemifene, and bremelanotide.
Women receiving placebo improved by 3.62 points on the Female Sexual Function Index (FSFI), compared to 5.35 points among women receiving active treatment. Based on this analysis, the authors concluded that 67.7% of the treatment effect for female sexual dysfunction is accounted for by placebo. These findings indicate that the available treatments for FSD are minimally superior to placebo; however, one might question if using a global measure of sexual functioning with the FSFI, rather than looking at specific aspects of sexual functioning, may be the best way to measure effectiveness of medications used to treat FSD. Nonetheless, this study highlights the importance of developing and evaluating more efficacious medications for the treatment of female sexual dysfunction.
Ruta Nonacs, MD PhD
Weinberger JM, Houman J, Caron AT, Patel DN, Baskin AS, Ackerman AL, Eilber KS, Anger JT. Obstet Gynecol. 2018 Aug;132(2):453-458.