Pain specialist management of sexual pain-IV. Pharmacological

The biopsychosocial model of care for women with sexual pain is a widely endorsed approach which includes pharmacologic treatments.

In this study we formulated a summary of current pharmacologic treatments for female sexual pain within a chronic pain paradigm and reviewed evidence for existing pharmacologic treatments and present promising treatment approaches.

Internet, PubMed, and Cochrane Library databases were searched for relevant articles on female sexual pain within the clinical purview and scope of practice of pain management.

A thorough review of the literature was conducted to include basic science studies, clinical trials, systematic reviews, consensus statements, and case-reports. An effort was made to also include a sampling of information on real-world patient self-directed therapies. The level of evidence for most pharmacologic therapies for female sexual pain is low. Results of clinical studies were summarized for a variety of sexual pain causes. The evidence for the use of topical and oral pharmacologic treatment strategies for sexual pain were reviewed.

Pharmacologic modalities play a significant role in treating female sexual pain, providing options to women as a part of multimodal care. Despite low evidence levels, current and novel treatment options have good safety and tolerability. Pain specialists can provide consultation on pharmacologic strategies to improve the care of women with chronic sexual pain.